Resectable invasive IPMN versus sporadic pancreatic adenocarcinoma of the head of the pancreas: Should these two different diseases receive the same treatment? A matched comparison study of the French Surgical Association (AFC)

被引：36

作者：

Duconseil, P. ^{[1
]}

Perinel, J. ^{[2
]}

Autret, A. ^{[3
]}

Adham, M. ^{[2
]}

Sauvanet, A. ^{[4
]}

Chiche, L. ^{[5
]}

Mabrut, J. -Y. ^{[6
]}

Tuech, J. -J. ^{[7
]}

Mariette, C. ^{[8
]}

Regenet, N. ^{[9
]}

Fabre, J. -M. ^{[10
]}

Bachellier, P. ^{[11
]}

Delpero, J. -R. ^{[12
]}

Paye, F. ^{[13
]}

Turrini, O. ^{[12
]}

机构：

[1] Hop Nord Marseille, Dept Surg, Marseille, France

[2] UCBL1, HCL, Hop Edouard Herriot, Dept Surg, Lyon, France

[3] Inst Paoli Calmettes, Dept Biostat, Marseille, France

[4] Hop Beaujon, Dept Surg, Paris, France

[5] Maison Haut Leveque, Dept Surg, Bordeaux, France

[6] Hop Croix Rousse, Dept Surg, Lyon, France

[7] Hop Charles Nicolle, Dept Surg, Rouen, France

[8] Hop Claude Huriez, Dept Surg, Lille, France

[9] Hop Hotel Dieu, Dept Surg, Nantes, France

[10] Hop St Eloi, Dept Surg, Montpellier, France

[11] Hop Hautepierre, Dept Surg, Strasbourg, France

[12] Inst Paoli Calmettes, Dept Surg, Marseille, France

[13] Hop St Antoine, Dept Surg, Paris, France

来源：

EJSO | 2017年 / 43卷 / 09期

关键词：

Invasive IPMN; Pancreatic adenocarcinoma; Staging; Adjuvant chemotherapy; PAPILLARY MUCINOUS NEOPLASMS; DUCTAL ADENOCARCINOMA; SURVIVAL; RESECTION; EXPERIENCE; OUTCOMES; CANCER; PROGNOSIS; TUMORS;

D O I：

10.1016/j.ejso.2017.06.011

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To compare survival and impact of adjuvant chemotherapy in patients who underwent pancreaticoduodenectomy (PD) for invasive intraductal papillary mucinous neoplasm (IIPMN) and sporadic pancreatic ductal adenocarcinoma (PDAC). Methods: From 2005 to 2012, 240 patients underwent pancreatectomy for IIPMN and 1327 for PDAC. Exclusion criteria included neoadjuvant treatment, pancreatic resection other than PD, vascular resection, carcinoma in situ, or < 11 examined lymph nodes. Thus, 82 IIPMN and 506 PDAC were eligible for the present study. Finally, The IIPMN group was matched 1:2 to compose the PDAC group according to TNM disease stage, perineural invasion, lymph node ratio, and margin status. Results: There was no difference in patient's characteristics, intraoperative parameters, postoperative outcomes, and histologic parameters. Overall survival and disease-free survival times were comparable between the 2 groups. In each group, overall survival time was significantly poorer in patients who did not achieve adjuvant chemotherapy (p = 0.03 for the IIPMN group; p = 0.03 for the PDAC group). In lymph-node negative patients of the IIPMN group, adjuvant chemotherapy did not have any significant impact on overall survival time (OR = 0.57; 95% CI [0.24-1.33]). Considering the whole population (i.e. patients with IIPMN and PDAC; n = 246), patients who did not achieve adjuvant chemotherapy had poorer survival (p < 0.01). Conclusions: The courses of IIPMN and PDAC were similar after an optimized stage-to-stage comparison. Adjuvant chemotherapy was efficient in both groups. However, in lymph node negative patients, adjuvant chemotherapy seemed not to have a significant impact. (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：1704 / 1710

页数：7

共 31 条

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