Role of Radical Antegrade Modular Pancreatosplenectomy for Adenocarcinoma of the Body and Tail of the Pancreas

Park, Hyo Jun; You, Dong Do; Choi, Dong Wook; Heo, Jin Seok; Choi, Seong Ho

doi:10.1007/s00268-013-2254-8

Cited by 53 publications

(78 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six retrospective trials that met the inclusion criteria were included in the meta-analysis for a total of 378 patients, including 152 patients undergoing RAMPS and 226 patients undergoing the standard procedure [20, 24, 27–30]. Figure 1 summarized the study flow.…”

Section: Resultsmentioning

confidence: 99%

“…However, in 2003, Strasberg described a new distal pancreatectomy technique, termed radical antegrade modular pancreatosplenectomy (RAMPS), to achieve negative posterior resection margins and to completely remove the N1 lymph nodes [19]. In the past decade, the RAMPS procedure has been increasingly applied, particularly in Japan and Korea [20–24]. However, the number of patients eligible for RAMPS is too small to consider any prospective randomized trial of RAMPS versus the standard procedure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis

Cao

et al. 2017

BMC Surg

View full text Add to dashboard Cite

BackgroundRadical antegrade modular pancreatosplenectomy (RAMPS), first reported by Strasberg in 2003, has attracted increasing attention in the treatment of left-sided pancreatic cancer. The limited number of cases eligible for RAMPS makes it difficult to perform any prospective randomized trial of RAMPS versus the standard procedure. Therefore, we performed this systemic review and meta-analysis of the current data to clarify the role of the RAMPS procedure.MethodsA literature search was performed in electronic databases, including PubMed, Medline, Embase, CNKI and the Cochrane Library. Studies comparing RAMPS with the standard procedure were included in this meta-analysis. R0 resection rate, recurrence rate at the end of the follow-up, overall survival (OS) and disease-free survival (DFS) were measured as primary outcomes. Revman 5.3 was used to perform the analysis.ResultsSix retrospective cohort studies with a total number of 378 patients were included in our analysis. Meta-analysis revealed that RAMPS was correlated with higher R0 resection rates [Odds Ratio (OR) 95% confidence interval (CI), 2.19 (1.16 ~ 4.13); P = 0.02] and successful harvest of more lymph nodes [weighted mean difference (WMD) 95% CI, 7.06 (4.52 ~ 9.60); P < 0.01] compared with the standard procedure. However, no statistically significant difference was found between the procedures with respect to recurrence rates [OR 95% CI, 0.66 (0.40 ~ 1.09); P = 0.10], OS [Hazard ratio (HR) 95% CI, 0.65 (0.42 ~ 1.00); P = 0.05] or DFS [HR 95% CI, 1.02 (0.62 ~ 1.68); P = 0.93].ConclusionsRAMPS is safe and oncologically superior to the standard procedure for the treatment of left-sided pancreatic cancer. However, high-grade evidence will be necessary to confirm the potential survival benefits of RAMPS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-017-0259-1) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis

Cao

et al. 2017

BMC Surg

View full text Add to dashboard Cite

show abstract

“…Two of the studies were conducted in Korea (8,18), one in Italy (19), one in the USA (20) and one in Japan (4). Overall, the five studies included 285 unique patients.…”

Section: Resultsmentioning

confidence: 99%

“…This procedure was adopted by minimally invasive pancreatic surgeons, which perform laparoscopic or robotic RAMPS, with great preliminary results (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Is Radical Antegrade Modular Pancreatosplenectomy the Solution? A Systematic Literature Review and Meta-Analysis

Dragomir¹,

Eftimie²

2017

chr

View full text Add to dashboard Cite

RezumatFond: RAMPS este considerată, în centrele cu volum chirurgical mare, ca fiind cea mai bună tehnică pentru tratamentul cancerelor corpului şi cozii de pancreas. Metodă: Baza de date PubMed a fost chestionată. Rezultatele studiilor ce compară RAMPS (Radical Antegrade Modular Pancreatosplenectomy) cu SRPS (Standard Retrograde Pancreatosplenectomy) au fost analizate prin metode de studiu meta-analitic. Rezultate: cinci studii publicate între 2013 şi 2016 au fost acceptate pentru studiu. 285 de pacienţi unici au fost incluşi, 135 de pacienţi în grupul RAMPS şi 150 în grupul SRPS. În ceea ce priveşte numărul de ganglioni limfatici rezecaţi, diferenţa medie a fost de 6,54. Această diferenţă a fost considerată ca fiind semnificativă din punct de vedere statistic, p < 0.00001. Rezecţia completă a fost obţinută la 115 din cei 129 de pacienţi operaţi prin tehnica RAMPS spre deosebire de 107 cazuri din 137 în cazul celor operaţi prin tehnica SRPS, RR fiind de 1,17 (95% CI; 1,04; 1,32). Supravieţuirea la un an a fost de 79,2% în grupul RAMPS, comparativ cu 64,29% în grupul SRPS. Această diferenţă este considerată semnificativă din punct de vedere statistic cu o valoare a p de 0,02. Concluzii: RAMPS este o procedură sigură pentru tratamentul chirurgical al adenocarcinoamelor corpului şi cozii de pancreas. RAMPS este superioară din punct de vedere al numărului ganglionilor rezecaţi şi al numărului rezecţiilor R0.Chirurgia (2017) Regarding retrieved lymph nodes, the mean difference was 6.54. This difference was considered to be statistical significant, P < 0.00001. A complete tumor resection was observed in 115 of 129 patients who underwent RAMPS and in the case of the standard procedure a R0 resection was obtained in 107 cases out of 137, the RR was 1.17 (95% CI, 1.04, 1.32). One-year overall survival was found to be 79.2% in the RAMPS groups compared with 64.29% in the SRPS group. This difference is considered statistically significant, with a P value of 0.02. Conclusions: RAMPS is a safe procedure for the treatment of adenocarcinomas of the body and tail of the pancreas. RAMPS procedure is superior to SRPS in terms of lymph node retrieval and R0 resections.

show abstract

“…Celiac LNs and superior mesenteric LNs were included in N1 LN group and recommended to be removed in all left-sided pancreatic cancers [12]. The notion was supported by recent studies that RAMPS is helpful in obtaining negative tangential margin and could enhance survival outcomes in patients with left-sided pancreatic cancer [34567]. …”

Section: Introductionmentioning

confidence: 99%

Extended versus peripancreatic lymph node dissection for the treatment of left-sided pancreatic cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

PurposeThe pathways of lymphatic metastases differ according to the tumor location in pancreatic cancer patients. However, it is unclear whether extended lymph node dissection (LND) is essential for all left-sided pancreatic cancer. The aim of this study is to evaluate the survival outcomes according to the extent of LND and tumor location in patients with left-sided pancreatic cancer.MethodsJanuary 2005 to December 2013, we retrospectively identified 107 patients who underwent curative intent surgery for left-sided pancreatic cancer. The left-sided pancreatic cancer was defined as a tumor located in pancreatic body or tail. The extent of LND was divided into 2 groups: extended LND and peripancreatic LND. The extended LND group included celiac and superior mesenteric LNs.ResultsWe included 107 patients with left-sided pancreatic cancer; 59 patients with pancreatic body cancer and 48 patients with pancreatic tail cancer. The median follow-up period was 17 months (range, 3–110 months). Fifty patients with pancreatic body cancer and 30 patients with pancreatic tail cancer underwent extended LND. In patients with pancreatic body cancer, extended LND was associated with improved disease-free survival (DFS) (P = 0.010) and overall survival (P = 0.014). However, extended LND was not associated with DFS in patients with pancreatic tail cancer.ConclusionExtended LND could improve survival in patients with pancreatic body cancer. However, extended LND had no survival benefit for the treatment of pancreatic tail cancer.

show abstract

Role of Radical Antegrade Modular Pancreatosplenectomy for Adenocarcinoma of the Body and Tail of the Pancreas

Cited by 53 publications

References 36 publications

Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis

Radical antegrade modular pancreatosplenectomy versus standard procedure in the treatment of left-sided pancreatic cancer: A systemic review and meta-analysis

Is Radical Antegrade Modular Pancreatosplenectomy the Solution? A Systematic Literature Review and Meta-Analysis

Extended versus peripancreatic lymph node dissection for the treatment of left-sided pancreatic cancer

Contact Info

Product

Resources

About