Surgical outcomes from nationwide implementation of the international best practice for locally advanced pancreatic cancer (PREOPANC-4) study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stoop Thomas F, Seelen Leonard W F, van 't Land Freek R, Scheepens Jacobien C M, Ali Mahsoem, van der Hout Anna C, van der Kolk B Marion, Bonsing Bert A, Lips Daan J, Manusama Eric R, Willemsen François E J A, Daams Freek, Kazemier Geert, Patijn Gijs A, de Hingh Ignace H, Wijsman Jan H, Schreinemakers Jennifer, Erdmann Joris I, Mieog J Sven D, Klaase Joost M, Rietjens Judith A C, Bosscha Koop, Beuk Lysanne P M, Nijkamp Maarten W, den Dulk Marcel, Kop Marnix P M, Liem Mike S L, Luyer Misha, Stommel Martijn W J, Busch Olivier R, Festen Sebastiaan, Bouwense Stefan, Karsten Tom M, van Ravens Tom W, Neumann Ulff P, de Meijer Vincent E, Nieuwenhuijs Vincent B, Draaisma Werner A, Derksen Wouter, Bollen Thomas L, Groot Koerkamp Bas, van Eijck Casper H J, Molenaar I Quintus, Wolfgang Christopher L, Del Chiaro Marco, Katz Matthew H G, Hackert Thilo, Wilmink Johanna W, van Santvoort Hjalmar C, de Wilde Roeland F, Besselink Marc G, Dutch Pancreatic Cancer Group
Аннотация
METHODS: A multidisciplinary protocol was designed in collaboration with four international experts and prospectively implemented nationwide within the Dutch Pancreatic Cancer Group (DPCG) (2022-2024). This observational cohort included consecutive patients diagnosed with LAPC, defined by DPCG criteria. Eligible patients had radiologically non-progressive disease after ≥4 months of multiagent chemotherapy. All patients who underwent resection were included in this safety analysis. A predefined subgroup analysis included patients with National Comprehensive Cancer Network (NCCN) LAPC. Primary outcomes included in-hospital/30-day major morbidity (that is Clavien-Dindo grade ≥IIIa) and mortality. The expected number of resections was 53.
RESULTS: Overall, 180 patients with LAPC underwent surgical exploration, of whom 155 (86%) underwent resection in 11 centres. Most resections (74%) were performed in the three LAPC surgical centres. An extended resection was performed for 77% of patients, including portomesenteric venous (60%), multivisceral (23%), and arterial (21%) resections. The in-hospital/30-day major morbidity rate was 44% and the mortality rate was 0.6%, both within pre-established safety benchmarks. Benchmarks were also reached for patients with NCCN LAPC (49% major morbidity and 2% mortality).
CONCLUSION: Nationwide implementation of the international best practice for LAPC was feasible with nearly three times more resections performed than expected, while morbidity and mortality remained well within predefined safety benchmarks.