Central pancreatectomy might be an acceptable surgical procedure for clinical T1 pancreatic body ductal adenocarcinoma: A multicenter retrospective analysis

J Hepatobiliary Pancreat Sci. 2023 Dec;30(12):1334-1342. doi: 10.1002/jhbp.1355. Epub 2023 Oct 4.

Abstract

Background: Central pancreatectomy (CP) is accepted as a function-preserving procedure for benign tumors. However, the indication of CP for pancreatic cancers is limited. This multicenter study aimed to clarify the indications of CP for clinical T1 pancreatic body cancer.

Methods: This multicenter study analyzed patients who underwent CP or distal pancreatectomy (DP) for clinical T1 pancreatic body cancer between 2013 and 2020 at three high-volume centers.

Results: A total of 50 patients were enrolled: nine patients, who underwent CP, were classified into the CP group, while 38 patients, who underwent DP, served as controls. Three patients converted CP to DP during operation were excluded. Five patients in the CP group and 15 patients in the control group underwent preoperative treatment. The 5-year survival rate was 100% in the CP group, and 42% (p = .040) in the control group. Recurrence was found in three patients in the CP group. Importantly, insulin was not required after surgery in patients in the CP group.

Conclusion: The clinical outcomes of CP were comparable to or even better than that of conventional pancreatectomy. Our collaborative study suggests that CP may be an acceptable therapeutic option for selected patients with clinical T1 pancreatic body cancer.

Keywords: central pancreatectomy; multicenter study; neoadjuvant therapy; organ preservation; pancreatic body cancer.

Publication types

  • Multicenter Study

MeSH terms

  • Carcinoma, Pancreatic Ductal* / pathology
  • Carcinoma, Pancreatic Ductal* / surgery
  • Humans
  • Pancreas / surgery
  • Pancreatectomy / methods
  • Pancreatic Neoplasms* / pathology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Treatment Outcome