Surgical treatment of resectable and borderline resectable pancreatic cancer in tertiary cancer center: the 6-year experience

Abstract

Objective: The aim of the study is to analyze the short and long-term results of surgical treatment of resectable and borderline-resectable patients during 2015-2017 (1st period) and 2018-2021 (2nd period). Material and Methods: A retrospective analysis of patients treated with pancreatic resection with (VR) and without portal or mesenteric vein resection (standard resection, SR) for exocrine pancreatic carcinoma in National Cancer Institute, Kyiv, Ukraine in 2015-2021. Results: 188 patients underwent surgical treatment, among which 67 received concomitant portal/mesenteric vein resection. Postoperative mortality was 10.04% (14.93% and 6.61% in VR and SR group, respectively, p=0.11). Textbook outcome rate was 67.3% vs 72.7% in VR and SR groups, respectively (p=0.57). Comparing 2015-2017 and 2018-2021 time periods, TO rate did not change for VR – 67.9% vs 66.8% (p>0.99), but tended to increase in SR group – 62.2% vs 80.4% (p=0.089).  Median overall survival was 17.03 month and did not differ between VR and SR. OS of all patients differed significantly between 2015-2017 and 2018-2021 – 13.8 vs 22.5 month (p=0.013). In multivariative analysis pancreatic head resection and lower tumor grade were positive prognostic factors, while age >65 and first study period – negative for OS. Conclusion: Extended due to venous resection pancreatectomies lead to comparable with standard procedures short-term and long-term results. The tumor grade G1-2, patient age less than 65, pancreaticoduodenal resection, and treatment period 2018-2021 were independent factors for better prognosis. Further prospective data is necessary to obtain representative results