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

Fox Chase Cancer Center

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

5 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

UN SDGs

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

SDG 3 Good Health and Well-being

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

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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",

month = apr,

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

language = "English",

volume = "225",

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T1 - Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

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 - Humans

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KW - Minimally Invasive Surgical Procedures/methods

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KW - Pancreas/surgery

KW - Pancreatic Neoplasms/pathology

KW - Pancreaticoduodenectomy/methods

KW - Postoperative Complications/epidemiology

KW - Retrospective Studies

KW - Conversion

KW - Survival

KW - Outcomes

KW - Minimally invasive

KW - Pancreas

KW - Cancer

UR - https://www.scopus.com/pages/publications/85141283973

UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000951936100001&DestLinkType=FullRecord&DestApp=WOS

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DO - 10.1016/j.amjsurg.2022.10.056

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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

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)

Biostatistics and Bioinformatics Facility

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Discrepancies in survival after conversion to open in minimally invasive pancreatoduodenectomy

Abstract

UN SDGs

Keywords

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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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