Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

Anthony M. Villano; Karen Ruth; Jason Castellanos; Jeffrey M. Farma; Sanjay S. Reddy

doi:10.1016/j.amjsurg.2022.10.056

Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

Anthony M. Villano, Karen Ruth, Jason Castellanos, Jeffrey M. Farma, Sanjay S. Reddy

Fox Chase Cancer Center

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

BACKGROUND: The extent by which conversion to open (CTO) during minimally invasive procedures for pancreatic cancer impact survival outcomes is not fully understood.

METHODS: The 2010-2017 National Cancer Database identified 12,424 non-metastatic patients who underwent pancreatoduodenectomy for ductal adenocarcinoma. Patients were stratified into three cohorts: open (OPD), completed MIPD (cMIPD), and CTO. Subgroups were dichotomized by hospital MIPD volume.

RESULTS: Across the study period, 80.6% of patients underwent OPD, 19.4% MIPD, and 24% were CTO. Median overall survival was worse after CTO (21.8 months) than for OPD (23.6 months) or cMIPD (25.2 months) (p < 0.001). Although this effect persisted for <10 MIPD/year, CTO did comparably to OPD at hospitals performing ≥10MIPD/year (CTO = 26.8 months, OPD = 27.9 months; p = 0.128). Ninety-day mortality after CTO was worse at ≤ 10 MIPD/year hospitals (9.3% vs. 2.6%).

CONCLUSIONS: Short and long-term survival is impacted by CTO after MIPD, especially at lower surgical volumes, stressing careful adoption while ascending the learning curve.

Original language	English
Pages (from-to)	728-734
Number of pages	7
Journal	American Journal of Surgery
Volume	225
Issue number	4
DOIs	https://doi.org/10.1016/j.amjsurg.2022.10.056
State	Published - Apr 2023

Keywords

Databases, Factual
Hospitals
Humans
Laparoscopy
Minimally Invasive Surgical Procedures/methods
Neoplasms/surgery
Pancreas/surgery
Pancreatic Neoplasms/pathology
Pancreaticoduodenectomy/methods
Postoperative Complications/epidemiology
Retrospective Studies
Conversion
Survival
Outcomes
Minimally invasive
Pancreas
Cancer

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.amjsurg.2022.10.056

Cite this

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title = "Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy",

abstract = "BACKGROUND: The extent by which conversion to open (CTO) during minimally invasive procedures for pancreatic cancer impact survival outcomes is not fully understood.METHODS: The 2010-2017 National Cancer Database identified 12,424 non-metastatic patients who underwent pancreatoduodenectomy for ductal adenocarcinoma. Patients were stratified into three cohorts: open (OPD), completed MIPD (cMIPD), and CTO. Subgroups were dichotomized by hospital MIPD volume.RESULTS: Across the study period, 80.6% of patients underwent OPD, 19.4% MIPD, and 24% were CTO. Median overall survival was worse after CTO (21.8 months) than for OPD (23.6 months) or cMIPD (25.2 months) (p < 0.001). Although this effect persisted for <10 MIPD/year, CTO did comparably to OPD at hospitals performing ≥10MIPD/year (CTO = 26.8 months, OPD = 27.9 months; p = 0.128). Ninety-day mortality after CTO was worse at ≤ 10 MIPD/year hospitals (9.3% vs. 2.6%).CONCLUSIONS: Short and long-term survival is impacted by CTO after MIPD, especially at lower surgical volumes, stressing careful adoption while ascending the learning curve.",

keywords = "Databases, Factual, Hospitals, Humans, Laparoscopy, Minimally Invasive Surgical Procedures/methods, Neoplasms/surgery, Pancreas/surgery, Pancreatic Neoplasms/pathology, Pancreaticoduodenectomy/methods, Postoperative Complications/epidemiology, Retrospective Studies, Conversion, Survival, Outcomes, Minimally invasive, Pancreas, Cancer",

author = "Villano, {Anthony M.} and Karen Ruth and Jason Castellanos and Farma, {Jeffrey M.} and Reddy, {Sanjay S.}",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2023",

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doi = "10.1016/j.amjsurg.2022.10.056",

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AU - Villano, Anthony M.

AU - Ruth, Karen

AU - Castellanos, Jason

AU - Farma, Jeffrey M.

AU - Reddy, Sanjay S.

PY - 2023/4

Y1 - 2023/4

N2 - BACKGROUND: The extent by which conversion to open (CTO) during minimally invasive procedures for pancreatic cancer impact survival outcomes is not fully understood.METHODS: The 2010-2017 National Cancer Database identified 12,424 non-metastatic patients who underwent pancreatoduodenectomy for ductal adenocarcinoma. Patients were stratified into three cohorts: open (OPD), completed MIPD (cMIPD), and CTO. Subgroups were dichotomized by hospital MIPD volume.RESULTS: Across the study period, 80.6% of patients underwent OPD, 19.4% MIPD, and 24% were CTO. Median overall survival was worse after CTO (21.8 months) than for OPD (23.6 months) or cMIPD (25.2 months) (p < 0.001). Although this effect persisted for <10 MIPD/year, CTO did comparably to OPD at hospitals performing ≥10MIPD/year (CTO = 26.8 months, OPD = 27.9 months; p = 0.128). Ninety-day mortality after CTO was worse at ≤ 10 MIPD/year hospitals (9.3% vs. 2.6%).CONCLUSIONS: Short and long-term survival is impacted by CTO after MIPD, especially at lower surgical volumes, stressing careful adoption while ascending the learning curve.

AB - BACKGROUND: The extent by which conversion to open (CTO) during minimally invasive procedures for pancreatic cancer impact survival outcomes is not fully understood.METHODS: The 2010-2017 National Cancer Database identified 12,424 non-metastatic patients who underwent pancreatoduodenectomy for ductal adenocarcinoma. Patients were stratified into three cohorts: open (OPD), completed MIPD (cMIPD), and CTO. Subgroups were dichotomized by hospital MIPD volume.RESULTS: Across the study period, 80.6% of patients underwent OPD, 19.4% MIPD, and 24% were CTO. Median overall survival was worse after CTO (21.8 months) than for OPD (23.6 months) or cMIPD (25.2 months) (p < 0.001). Although this effect persisted for <10 MIPD/year, CTO did comparably to OPD at hospitals performing ≥10MIPD/year (CTO = 26.8 months, OPD = 27.9 months; p = 0.128). Ninety-day mortality after CTO was worse at ≤ 10 MIPD/year hospitals (9.3% vs. 2.6%).CONCLUSIONS: Short and long-term survival is impacted by CTO after MIPD, especially at lower surgical volumes, stressing careful adoption while ascending the learning curve.

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KW - Pancreaticoduodenectomy/methods

KW - Postoperative Complications/epidemiology

KW - Retrospective Studies

KW - Conversion

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KW - Minimally invasive

KW - Pancreas

KW - Cancer

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SN - 0002-9610

VL - 225

SP - 728

EP - 734

JO - American Journal of Surgery

JF - American Journal of Surgery

IS - 4

ER -

Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

Abstract

Keywords

UN SDGs

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New Findings from Fox Chase Cancer Center in the Area of Pancreatoduodenectomy Described (Discrepancies In Survival After Conversion To Open In Minimally Invasive Pancreatoduodenectomy)

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Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

Abstract

Keywords

UN SDGs

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New Findings from Fox Chase Cancer Center in the Area of Pancreatoduodenectomy Described (Discrepancies In Survival After Conversion To Open In Minimally Invasive Pancreatoduodenectomy)

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