Journal of surgical oncology · 2025
Minimally Invasive Versus Open Resection for Solid Pseudopapillary Tumors of the Pancreas: A Propensity Score-Matched Analysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wong Paul, Todeschini Letizia, Pollini Tommaso, Hernandez Sophia, Zampese Marco, Aguilar Luis Laurean, Peng June S, Thornblade Lucas W, Adam Mohamed A, Alseidi Adnan, Corvera Carlos U, Hirose Kenzo, Kirkwood Kimberly S, Nakakura Eric K, Maker Ajay V
Аннотация
BACKGROUND AND OBJECTIVES: Solid pseudopapillary tumors (SPTs) of the pancreas occur predominantly in young females and possess low malignant potential. In this study, clinicopathologic, perioperative, and long-term outcomes are compared in SPT patients that received open or minimally invasive (MIS) resection.
METHODS: The National Cancer Database (2010-2020) was queried to identify all patients with SPTs that underwent an open or MIS surgical resection. Propensity score matching analysis was conducted through 1:1 matching based on the nearest neighbor method.
RESULTS: Of 835 patients, 59.7% received an open approach and 40.3% were performed MIS. Over the decade, MIS approach increased from 7.7% to 60.0% for distal pancreatectomy (DP) and 15.4% to 30.2% for pancreaticoduodenectomy (PD) (both p < 0.05). There were no differences in lymphadenectomy (>15 nodes) or resection margin positivity. Shorter length of stay was noted for MIS resections (PD: 5 vs. 8 days, p < 0.001; DP: 5 vs. 6 days, p = 0.022), and no difference was appreciated in 30-day readmission rates. There was no difference in overall survival between open and MIS approaches for PD and DP.
CONCLUSIONS: Minimally invasive resections for SPTs have increased by ~40% over a decade and may offer a safe and feasible alternative to open resection that provides similar perioperative and long-term oncologic outcomes.
METHODS: The National Cancer Database (2010-2020) was queried to identify all patients with SPTs that underwent an open or MIS surgical resection. Propensity score matching analysis was conducted through 1:1 matching based on the nearest neighbor method.
RESULTS: Of 835 patients, 59.7% received an open approach and 40.3% were performed MIS. Over the decade, MIS approach increased from 7.7% to 60.0% for distal pancreatectomy (DP) and 15.4% to 30.2% for pancreaticoduodenectomy (PD) (both p < 0.05). There were no differences in lymphadenectomy (>15 nodes) or resection margin positivity. Shorter length of stay was noted for MIS resections (PD: 5 vs. 8 days, p < 0.001; DP: 5 vs. 6 days, p = 0.022), and no difference was appreciated in 30-day readmission rates. There was no difference in overall survival between open and MIS approaches for PD and DP.
CONCLUSIONS: Minimally invasive resections for SPTs have increased by ~40% over a decade and may offer a safe and feasible alternative to open resection that provides similar perioperative and long-term oncologic outcomes.