Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial

Hilst, Jony van; Rooij, Thijs de; Bosscha, K.; Brinkman, David J.; Dieren, Susan van; Dijkgraaf, Marcel G. W.; Gerhards, Michael F.; Hingh, Ignace H. J. T. de; Karsten, Tom; Lips, Daniel J.; Luyer, Misha; Busch, Olivier R.; Festen, Sebastiaan; Besselink, Marc G.; Marsman, Hendrik A.; Gulik, Thomas M. van; Wicherts, Dennis A.; Eshuis, Wietse J.; Stibbe, L.; Dijkum, Els J. Nieveen van; Hooft, Janine E Van; Fockens, Paul; Laarhoven, Hanneke W. van; Wilmink, Johanna W.; Vijver, Marcel J Van de; Bijlsma, Maarten F.; Verheij, Joanne; Nio, C. Yung; Lienden, Krijn P. van; Tienhoven, Geertjan van; Schoorlemmer, Annuska; Creemers, Geert-Jan; Eijck, Casper H. van; Koerkamp, B. Groot; Bruno, Marco J.; Eskens, Ferry A.L.M.; Nuyttens, J.; Pek, Chulja J.; Schelling, George P. van der; Seerden, Tom; Patijn, Gijs A.; Nieuwenhuijs, Vincent B.; Groot, Jan Willem de; Bonsing, Bert A.; Vahrmeijer, Alexander L.; Swijnenburg, Rutger-Jan; Mieog, J. Sven D.; Harst, Erwin van der; Dulk, Marcel den; Damink, Steven Olde; Dejong, C. H. C.; Dam, Ronald M. van; Vos, Judith MPGM De; Liem, Mike S L; Laarhoven, Cees J van; Goor, Harry van; Boezem, Peter B. van den; Kolk, B.M. van der; Stommel, Martijn W J; Hermans, John J.; Geenen, E.J. van; Radema, Sandra A.; Brosens, Lodewijk A.A.; Scheepers, Joris J.; Roos, Daphne; Boerma, Djamilla; Riele, Wouter te; Santvoort, Hjalmar C. van; Bollen, Thomas L.; Wit, F.; Molenaar, I. Quintus; Mohammad, Nadia Haj; Leeuwen, Maarten S. van; Roele, Annemarie; Jong, K. P. de; Meijer, Vincent E de; Klaase, Joost M.; Kazemier, Geert; Zonderhuis, B.; Daams, Freek; Meijerink, Martijn R.; Latenstein, Anouk E J; Rijssen, L.B. van; Nota, C.; Halsema, Emo van; Veldhuisen, Eran van; Vogel, Jantien A.; Janssen, Kiki; Scholten, Lianne; Daamen, Lois A; Walma, Marieke S.; Strijker, Marin; Prins, Mariska; Zwart, M.; Suker, Mustafa; Rombouts, Steffi; Mungroop, Timothy H.; Vissers, F.; Korrel, Maarten

doi:10.1016/s2468-1253(19)30004-4

Cited by 417 publications

(269 citation statements)

References 31 publications

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“…Despite being a rare tumor, the incidence of PNETs is on the rise with more PNETs being resected annually than a decade ago 1 . Surgery remains the only chance of long‐term cure, yet can be associated with considerable perioperative morbidity 6,9 . Traditionally, a number of metrics have been used to assess the quality of surgical care delivered to patients 6,9,18 .…”

Section: Discussionmentioning

confidence: 99%

“…Quality of surgical care impacts patient experience, and may influence long‐term outcomes and even the risk of developing a recurrence. Traditionally, isolated outcome measures have been used to assess performance relative to complex, high‐risk surgeries such as hepato‐pancreato‐biliary, esophageal, and colorectal surgery 6‐9 . Composite measures have recently been suggested to assess more accurately the quality of care delivered to patients compared with single outcome indicators.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Heidsma

Hyer

Tsilimigras

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: We sought to define the incidence and impact of Textbook Outcome (TO) on disease-free survival [DFS] among patients undergoing resection of pancreatic neuroendocrine tumors (PNET). Methods: Patients undergoing resection of a PNET between 2000 and 2016 wereidentified using a multi-institutional database. TO was defined as no postoperative severe complications (Clavien-Dindo grade ≥ III), no 90-day mortality, no prolonged length-ofhospital stay (LOS) (ie, > 75th percentile), no 90-day readmission after discharge, and R0 resection. The 5-year DFS was calculated and the association with TO was examined.Results: Among 821 patients with a PNET, median tumor size was 2.1 cm (IQR 1.4-14.6).Resection consisted of pancreatoduodenectomy (PD) (n = 231, 28.1%), distal pancreatectomy (DP) (n = 492, 59.9%), and enucleation (EN) (n = 98, 11.9%). Overall TO rate was 49.3% (n = 405). The incidence of TO varied by procedure type (PD: 32.5% vs DP: 56.7% vs EN: 52.0%; P < .001). After adjusting for all competing factors, achievement of a TO was independently associated with improved DFS (hazard ratio: 0.54, 95% CI, 0.35-0.81; P = .003). Conclusions:Only one in two patients undergoing resection of a PNET achieved a TO, which varied markedly based on procedure type. Achievement of a TO was associated with improved DFS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Heidsma

Hyer

Tsilimigras

et al. 2020

Journal of Surgical Oncology

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“…Several studies from high-volume centers have reported that MIPD might be feasible and confer advantages over OPD for benign lesions and periampullary malignancy [23][24][25]. However, reservations concerning the safety of MIPD persist as the majority of hospitals performing MIPD were low-volume centers, and its use has been associated with increased morbidity and mortality [26][27][28]. In addition, MIPD for PDAC is yet to show generalizable indication because of the complex relationships between major surrounding structures, inflammatory changes around the head of the pancreas, and invasion of major vessels.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Kwon

Song

Park

et al. 2020

Cancers

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Background: Few studies have compared perioperative and oncological outcomes between minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective review of patients undergoing MIPD and OPD for PDAC from January 2011 to December 2017 was performed. Perioperative, oncological, and survival outcomes were analyzed before and after propensity score matching (PSM). Results: Data from 1048 patients were evaluated (76 MIPD, 972 OPD). After PSM, 73 patients undergoing MIPD were matched with 219 patients undergoing OPD. Operation times were longer for MIPD than OPD (392 vs. 327 min, p < 0.001). Postoperative hospital stays were shorter for MIPD patients than OPD patients (12.4 vs. 14.2 days, p = 0.040). The rate of overall complications and postoperative pancreatic fistula did not differ between the two groups. Adjuvant treatment rates were higher following MIPD (80.8% vs. 59.8%, p = 0.002). With the exception of perineural invasion, no differences were seen between the two groups in pathological outcomes. The median overall survival and disease-free survival rates did not differ between the groups. Conclusions: MIPD showed shorter postoperative hospital stays and comparable perioperative and oncological outcomes to OPD for selected PDAC patients. Future randomized studies will be required to validate these findings.

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“…Considering the increase in minimally invasive PD, this unmet clinical need should be resolved for safe implementation of minimally invasive PD in clinical practice. 11 We developed an in vivo porcine model mimicking remnant soft pancreas with a small pancreatic duct during PD. A specialized catheter may be very helpful for preparing this model, 12 although a typical catheter or curved guide wire can be used.…”

Section: Discussionmentioning

confidence: 99%

Developing an in vivo porcine model of duct‐to‐mucosa pancreaticojejunostomy (Yonsei‐PJ^DTM)

Choi

Kang

2020

Annals of Gastroent Surgery

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Laparoscopic pancreaticoduodenectomy (LPD) is technically feasible, but its safety is still controversial. Pancreas texture and the small size of the main pancreatic duct indicate laparoscopic pancreaticoduodenectomy (LPD) as a challenging procedure. Thus, LPD could be a risk factor for postoperative pancreatic fistula (POPF), longer hospital stay, and delayed adjuvant chemotherapy that affects long‐term oncologic outcome. So, it is important to promote education on LPD especially techniques for pancreaticojejunostomy. A porcine model for duct‐to‐mucosa pancreaticojejunostomy (PJ) (Yonsei‐PJDTM) was developed, and details of the model will be described in this report.

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Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial

Cited by 417 publications

References 31 publications

Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Developing an in vivo porcine model of duct‐to‐mucosa pancreaticojejunostomy (Yonsei‐PJ^DTM)

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Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial

Cited by 417 publications

References 31 publications

Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Developing an in vivo porcine model of duct‐to‐mucosa pancreaticojejunostomy (Yonsei‐PJDTM)

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Developing an in vivo porcine model of duct‐to‐mucosa pancreaticojejunostomy (Yonsei‐PJ^DTM)