European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Impact of pancreatic transection level on survival outcomes and glycemic control following distal pancreatectomy for pancreatic tail cancer: A multicenter cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lee Jun Suh, Cassese Gianluca, Yoon Yoo-Seok, Han Ho-Seong, Lee Boram, Park Yeshong, Jang Jin-Young, Kwon Wooil, Lim Chang-Sup
Аннотация
BACKGROUND: The optimal transection level (TL) during distal pancreatectomy (DP) for pancreatic tail cancer remains unclear. This study evaluated the effect of TL on survival and glucose metabolism.
METHODS: We retrospectively reviewed 320 patients undergoing DP between 2000 and 2018 at three centers. Patients were grouped as proximal transection (PT, n = 264) or distal transection (DT, n = 56) relative to the aorta. Perioperative, oncologic, and metabolic outcomes were compared, including a propensity score-matched analysis.
RESULTS: Operation time and blood loss were greater in PT, which also yielded more lymph nodes (14 vs. 10, P < 0.01), though R0 resection and nodal positivity were similar. In the matched cohort, disease-free survival (17.7 vs. 15.3 months, P = 0.76) and overall survival (27.0 vs. 30.9 months, P = 0.64) did not differ between PT and DT. Multivariable analysis confirmed no association of TL with survival. Among non-diabetic patients, PT was associated with a greater rise in HbA1c at 1 year (0.57 % vs. 0.16 %; P = 0.056), suggesting impaired glycemic control.
CONCLUSIONS: Transection level does not influence oncologic outcomes in DP for pancreatic tail cancer but may affect postoperative glucose regulation.
METHODS: We retrospectively reviewed 320 patients undergoing DP between 2000 and 2018 at three centers. Patients were grouped as proximal transection (PT, n = 264) or distal transection (DT, n = 56) relative to the aorta. Perioperative, oncologic, and metabolic outcomes were compared, including a propensity score-matched analysis.
RESULTS: Operation time and blood loss were greater in PT, which also yielded more lymph nodes (14 vs. 10, P < 0.01), though R0 resection and nodal positivity were similar. In the matched cohort, disease-free survival (17.7 vs. 15.3 months, P = 0.76) and overall survival (27.0 vs. 30.9 months, P = 0.64) did not differ between PT and DT. Multivariable analysis confirmed no association of TL with survival. Among non-diabetic patients, PT was associated with a greater rise in HbA1c at 1 year (0.57 % vs. 0.16 %; P = 0.056), suggesting impaired glycemic control.
CONCLUSIONS: Transection level does not influence oncologic outcomes in DP for pancreatic tail cancer but may affect postoperative glucose regulation.