Survival outcomes of pancreaticoduodenectomy versus extended pancreaticoduodenectomy procedure for pancreatic head carcinoma: a propensity score matching study

Abstract

Background: It is unclear if the modified extended pancreaticoduodenectomy (PD) has better outcome superior the conventional PD for patients with pancreatic head carcinoma (PHC). The objective of this study is to compare the survival outcomes of the classic PD procedure and the modified extended PD procedure for PHC.Methods: A total of 7,084 resected PHC patients with PD and extended PD procedure from the SEER database from 2004 to 2014 were stratified. With the utilization of propensity score matching (PSM), patient baseline characteristics were balanced to decrease the bias. Overall survival (OS) and cancer-specific survival (CSS) were analyzed in both groups.Results: Of the 7,084 patients, 6,541 (92.3%) and 543 (7.7%) patients received PD and extended PD surgical procedures, respectively. After 2:1 ratio of PSM, 543 patients with extended PD procedure and 1,084 patients with PD procedure were completely matched. The median CSS and OS for PD and extended PD group were 20.0 and 19.0 months, and 19.0 and 18.0 months, respectively. The 5-year CSS and OS rates for PD and extended PD group were 17.5% and 16.1%, and 13.9% and 13.1%, respectively.Conclusions: There is no distinct difference in survival outcomes between PD and extended PD procedure in patients with PHC.

Comprehensive Diagnostic Nomogram for Predicting Clinically Relevant Postoperative Pancreatic Fistula After Pancreatoduodenectomy

“…All patients underwent the standard Whipple procedure ( 22 ) performed by experienced attending surgeons who were able to independently perform more than 30 cases per year. The standard Whipple technique was performed as follows (1): first the Kocher technique was performed, the space between the descending part of the duodenum and the inferior vena cava was separated, the horizontal part of the duodenum from the retroperitoneum was freed, and the inferior vena cava, portal vein, and its branches were exposed (2); the gastrocolic ligament were then separated and the omentum sac entered to expose the tail of the pancreas (3); the anterior lobe of the transverse mesangial colon and dorsal pancreas were separated, and dissection was performed on the Henle trunk, right gastro-omental vein, superior anterior pancreaticoduodenal vein, accessory right colon vein, lower edge of the pancreatic head, and dorsal blood vessels (4); the hepatoduodenal ligament was dissected, and the blood vessels and bile ducts of the hilar exposed to free the common hepatic artery, right gastric artery, and splenic artery (5); a linear cutting closer was used to cut and retract the stomach, pylorus, and omentum, then the pancreas was exposed and its head and neck removed to free the uncinate process and superior mesenteric vein, the jejunum was also removed 20 cm away from the Treitz ligament (6); finally, pancreaticojejunostomy, cholangijejunostomy, and gastrojejunostomy were performed in this order.…”

Erratum to survival outcomes of pancreaticoduodenectomy versus extended pancreaticoduodenectomy procedure for pancreatic head carcinoma: a propensity score matching study

“…In the March 2020 issue of Translational Cancer Research , the article “Survival outcomes of pancreaticoduodenectomy versus extended pancreaticoduodenectomy procedure for pancreatic head carcinoma: a propensity score matching study” authored by Pu et al ( 1 ) was published with some errors in Figure 3 during the editorial typesetting process. The figure legends remain intact.…”