Survival After Pancreatectomy With Major Arterial Resection and Reconstruction

Stitzenberg, Karyn B.; Watson, James C.; Ab, Roberts; Kagan, Steven A.; Cohen, Steven J.; Konski, André; Hoffman, John P.

doi:10.1245/s10434-008-9844-y

Cited by 104 publications

(82 citation statements)

References 18 publications

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“…A larger series examining arterial resections for pancreatic adenocarcinoma was reported by Stitzenberg et al [25]. In their series, 12 patients underwent pancreaticoduodenectomy with arterial resection (celiac axis resection, n=10; and hepatic artery resection, n=2).…”

Section: Oncologic Controversy: Pancreaticoduodenectomy and Arterial mentioning

confidence: 98%

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Schoellhammer

Goldner

Kim

et al. 2013

Indian J Surg Oncol

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Pancreatic adenocarcinoma is the most common pancreatic malignancy, and it occurs most commonly in the pancreatic head. It has a relatively low incidence; however it is a deadly disease and is the fourth most common cause of cancer deaths for males and females in the United States. Surgical resection in the form of pancreaticoduodenectomy is the mainstay of treatment and can lead to improved overall survival as well as the possibility of a cure, although only 10 % of patients are resectable at presentation. In an attempt to improve outcomes and survival, surgeons over the decades have employed various aggressive resectional strategies to combat this disease. In this paper we review the development of pancreaticoduodenectomy and touch on the role played by the American surgeon Allan Whipple in this development. We review modern data regarding radical pancreaticoduodenectomy and extended lymphadenectomy for pancreatic head cancers, as well as data and controversies regarding arterial and venous resection performed during the course of pancreaticoduodenectomy. The role of extended and vascular resections in the treatment of pancreatic neuroendocrine tumors in contrast to adenocarcinomas is also examined. We summarize the current state of data regarding radical pancreaticoduodenectomy and discuss pushing the boundaries of surgical resection to help improve outcomes for select groups of patients.

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Section: Oncologic Controversy: Pancreaticoduodenectomy and Arterial mentioning

confidence: 98%

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Schoellhammer

Goldner

Kim

et al. 2013

Indian J Surg Oncol

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“…Highvolume centers, with expertise in en bloc resection of the hepatic artery, superior mesenteric artery, or even the celiac trunk itself [86][87][88] have shown good survival outcomes.…”

Section: Vascular Resectionmentioning

confidence: 99%

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Singh

Chaudhary

2015

Indian J Surg

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Pancreatic adenocarcinoma still ranks high among cancer-related deaths worldwide. In spite of substantial strides in preoperative staging, surgery, perioperative care, and adjuvant treatment, the survival still remains dismal. A number of patient-, disease-, and surgeon-related factors play a role in deciding the eventual outcome of the patient. The aim of this commentary is to review the current knowledge of various factors and the recent advances that impact the survival of patients with pancreatic adenocarcinoma. A search of scientific literature using Embase and MEDLINE, for the years 1985-2015, was carried out for search terms Bpancreatic cancer^and Bsurvival.^Further search was based on the various specific prognostic factors that contribute towards survival of patients with pancreatic cancer found in the literature. Most of the studies used for this review include those that deal with pancreatic head cancers, some include patients with pancreatic cancers in all locations while very few included patients with tumors of body and tail only. In spite of significant developments in pre-and perioperative management, increased rates of margin-negative resections, and use of adjuvant treatment, the survival rates of pancreatic cancer patients remains poor. A paradigm shift with more effective adjuvant regimen and genetic interventions may help change the outcomes of patients with pancreatic cancer.

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“…Thus, a small portion of portal vein encroachment may be considered resectable in most, but not all centres dealing with these cancers [40,41]. However, arterial involvement is considered operable only by a minority of the centres of excellence and, even in those series of patients, the peri-operative outcome is not good [41,42]. These aspects account for the variability in the resectability criteria for locally advanced disease.…”

Section: Post-test Variabilitymentioning

confidence: 99%

The role of laparoscopy and laparoscopic ultrasound in the preoperative staging of pancreatico-biliary cancers – A meta-analysis

Hariharan

Constantinides

Froeling

et al. 2010

European Journal of Surgical Oncology (EJSO)

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Survival After Pancreatectomy With Major Arterial Resection and Reconstruction

Abstract: Resection of the HA or CA with reconstruction may prolong survival for selected patients who undergo pancreatic resection after neoadjuvant therapy. However, this aggressive approach did not result in any long-term survivors in our series.

Cited by 104 publications

References 18 publications

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Beyond the Whipple Operation: Radical Resections for Cancers of the Head of the Pancreas

Improving Survival of Pancreatic Cancer. What Have We Learnt?

The role of laparoscopy and laparoscopic ultrasound in the preoperative staging of pancreatico-biliary cancers – A meta-analysis

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