Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Comparison of Survival Outcomes between Radical Antegrade Modular Pancreato-Splenectomy and Conventional Distal Pancreato-Splenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis

Hee Joon Kim
* ORCID logo ,
Sang Hyun Shin
* ,
Jaewoo Kwon
ORCID logo ,
Huisong Lee
,
Hongbeom Kim
,
Sung Hyun Kim
ORCID logo ,
Jae Do Yang
,
Woohyung Lee
ORCID logo ,
Jun Suh Lee
Version 1 : Received: 13 March 2024 / Approved: 13 March 2024 / Online: 13 March 2024 (16:07:20 CET)

A peer-reviewed article of this Preprint also exists.

Kwon, J.; Lee, H.; Kim, H.; Kim, S.H.; Yang, J.D.; Lee, W.; Lee, J.S.; Shin, S.H.; Kim, H.J. Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis. Cancers 2024, 16, 1546. Kwon, J.; Lee, H.; Kim, H.; Kim, S.H.; Yang, J.D.; Lee, W.; Lee, J.S.; Shin, S.H.; Kim, H.J. Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis. Cancers 2024, 16, 1546.

Abstract

(1) Background: The aim of this study was to compare the survival benefit of radical ante-grade-modular pancreato-splenectomy (RAMPS) with conventional distal pancreato-splenectomy (cDPS) in left-sided pancreatic cancer. (2) Methods: A retrospective propensity score matching (PSM) analysis was conducted on 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer at four tertiary cancer centers. The study assessed prognostic factors and com-pared survival and operative outcomes. (3) Results: After PSM, 99 patients were matched in each group. RAMPS resulted in a higher retrieved lymph node count than cDPS (15.0 vs. 10.0, p < 0.001). No significant differences were observed between the two groups in terms of R0 resection rate, blood loss, hospital stay, or morbidity. The 5-year overall survival rate was similar in both groups (cDPS vs. RAMPS, 44.4% vs. 45.2%, p = 0.853), and disease-free survival was also comparable. Multivariate analysis revealed that ASA score, preoperative CA19-9, histologic differentiation, R1 resection, adjuvant treatment, and lymphovascular invasion were significant prognostic factors for overall survival. Preoperative CA19-9, histologic differentiation, T-stage, adjuvant treatment, and lymphovascular invasion were independent significant prognostic factors for disease-free survival. (4) Conclusions: Although RAMPS resulted in a higher retrieved lymph node count, survival outcomes were not different between two groups. RAMPS was a surgical option to achieve R0 resection rather than a standard procedure. Adjuvant treatment was an independent prognostic factor for both overall and disease-free survival.

Keywords

pancreatic neoplasm; pancreatectomy; survival; prognosis

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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