Article ; Online: Pancreaticoduodenectomy with right hemicolectomy for advanced malignancy: a single UK hepatopancreaticobiliary centre experience.
2022 Volume 25, Issue 1, Page(s) 16–23
Abstract: Aim: Locally advanced intestinal neoplasms including colon cancer may require radical en bloc pancreaticoduodenectomy and right hemicolectomy (PD-RC) to achieve curative, margin-negative resection, but the safety and benefit of this uncommon procedure ... ...
| Abstract | Aim: Locally advanced intestinal neoplasms including colon cancer may require radical en bloc pancreaticoduodenectomy and right hemicolectomy (PD-RC) to achieve curative, margin-negative resection, but the safety and benefit of this uncommon procedure has not been established. The Association of Coloproctology of Great Britain and Ireland IMPACT initiative has also highlighted a lack of awareness about current services available within the UK for patients with advanced colorectal cancer and concerns about low-volume centres managing complex cases. Thus, we aimed to review the feasibility, safety and long-term outcomes of this procedure at a single high-volume hepatopancreaticobiliary surgery unit in the UK. Method: A retrospective cohort study was performed using a database of all consecutive patients with intestinal cancer who had been referred to our regional advanced multidisciplinary team and undergone PD-RC in a 7-year period (2013-2020). Clinico-pathological and outcome data were reviewed. Results: Ten patients (mean age 54 ± 13, 8/10 men) were identified. Final histology revealed the primary tumour sites were colon (n = 7) and duodenum (n = 3). R0 resection was achieved in all cases. The major complication rate (Clavien-Dindo ≥ 3) was 10% (1/10) with no deaths within 90 days of surgery. The Kaplan-Meier estimated 5-year overall survival was 83.3% (95% CI 58.3%-100%). Univariate survival analysis identified perineural invasion and extra-colonic origin as predictors of poor survival (log-rank P < 0.05). Conclusion: En bloc PD-RC for locally advanced intestinal cancer can be performed safely with a high proportion of margin-negative resections and resultant long-term survival in carefully selected patients. |
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| MeSH term(s) | Male ; Humans ; Pancreaticoduodenectomy/methods ; Retrospective Studies ; Colonic Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Colectomy/methods |
| Language | English |
| Publishing date | 2022-09-01 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 1440017-0 |
| ISSN | 1463-1318 ; 1462-8910 |
| ISSN (online) | 1463-1318 |
| ISSN | 1462-8910 |
| DOI | 10.1111/codi.16303 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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