Xiong J, et al. - Here, researchers performed a comparison of the clinical outcomes between total pancreatectomy (TP) and pancreaticoduodenectomy (PD) in patients with pancreatic ductaladenocarcinoma (PDAC) was performed. In this study, the major morbidity was not significantly different between the TP and PD groups. In addition, the rate of 5-year overall survival was not significant between the matched PD and TP groups. Thereby suggesting that TP can be considered as safe, feasible, and efficacious as PD for patients with PDAC.

Methods

• Researchers selected a total of 375 patients from their center's database in China and classified them into two groups: the PD group (n = 325) and the TP group (n = 50).
• They conducted a matched-pair analysis of the patients with a ratio of 1:1.
• They performed a univariate and multivariate survival analyses for overall survival.

Results

• Overall morbidity was lower in the PD group than in the TP group (31.4% vs 52%, respectively,P=0.004).
• However, no significant difference was observed in major morbidity between the two groups (24.9% vs 30%, P=0.455).
• The PD group indicated markedly higher rates of 5-year overall (P=0.043) and disease-free (P=0.037) survival.
• In addition, in univariate and multivariate analyses, adjuvant chemotherapy (HR = 0.684, 95%CI = 0.545–0.860, P=0.001) and margin resection status (HR = 1.666, 95%CI = 1.196–2.321, P=0.003) were significant prognostic factors.
• After the matched-pair analysis, no significant differences were observed between the two groups regarding postoperative complications and overall survival.
• However, the matched PD group indicated greater estimated blood loss (P=0.037) and blood transfusion (56% vs 36%, P=0.045).