Minimally invasive versus open distal pancreatectomy for pancreatic neuroendocrine tumors: An analysis from the U.S. neuroendocrine tumor study group.

Authors:
Xu-Feng Zhang
Xu-Feng Zhang
Xi'an Jiaotong University
China
George Poultsides
George Poultsides
Stanford University Medical Center
United States
Eleftherios Makris
Eleftherios Makris
University of California Davis
Flavio Rocha
Flavio Rocha
Harvard Medical School
United States
Zaheer Kanji
Zaheer Kanji
Digestive Disease Institute
Oklahoma City | United States
Sharon Weber
Sharon Weber
University of Wisconsin
United States
Ryan Fields
Ryan Fields
Washington University School of Medicine
United States

J Surg Oncol 2019 Apr 18. Epub 2019 Apr 18.

Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.

Background: To determine short- and long-term oncologic outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for the treatment of pancreatic neuroendocrine tumor (pNET).

Methods: The data of the patients who underwent curative MIDP or ODP for pNET between 2000 and 2016 were collected from a multi-institutional database. Propensity score matching (PSM) was used to generate 1:1 matched patients with MIDP and ODP.

Results: A total of 576 patients undergoing curative DP for pNET were included. Two hundred and fourteen (37.2%) patients underwent MIDP, whereas 362 (62.8%) underwent ODP. MIDP was increasingly performed over time (2000-2004: 9.3% vs 2013-2016: 54.8%; P < 0.01). In the matched cohort (n = 141 in each group), patients who underwent MIDP had less blood loss (median, 100 vs 200 mL, P < 0.001), lower incidence of Clavien-Dindo ≥ III complications (12.1% vs 24.8%, P = 0.026), and a shorter hospital stay versus ODP (median, 4 versus 7 days, P = 0.026). Patients who underwent MIDP had a lower incidence of recurrence (5-year cumulative recurrence, 10.1% vs 31.1%, P < 0.001), yet equivalent overall survival (OS) rate (5-year OS, 92.1% vs 90.9%, P = 0.550) compared with patients who underwent OPD.

Conclusion: Patients undergoing MIDP over ODP in the treatment of pNET had comparable oncologic surgical metrics, as well as similar long-term OS.

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Source
http://dx.doi.org/10.1002/jso.25481DOI Listing
April 2019
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