@article{5f6a2f92cc5145f5ab7a28283fb62a7a,
title = "Nationwide Outcome of Gastrectomy with En-Bloc Partial Pancreatectomy for Gastric Cancer",
abstract = "Background: Radical gastrectomy is the cornerstone of the treatment of gastric cancer. For tumors invading the pancreas, en-bloc partial pancreatectomy may be needed for a radical resection. The aim of this study was to evaluate the outcome of gastrectomies with partial pancreatectomy for gastric cancer. Methods: Patients who underwent gastrectomy with or without partial pancreatectomy for gastric or gastro-oesophageal junction cancer between 2011 and 2015 were selected from the Dutch Upper GI Cancer Audit (DUCA). Outcomes were resection margin (pR0) and Clavien–Dindo grade ≥ III postoperative complications and survival. The association between partial pancreatectomy and postoperative complications was analyzed with multivariable logistic regression. Overall survival of patients with partial pancreatectomy was estimated using the Kaplan–Meier method. Results: Of 1966 patients that underwent gastrectomy, 55 patients (2.8%) underwent en-bloc partial pancreatectomy. A pR0 resection was achieved in 45 of 55 patients (82% versus 85% in the group without additional resection, P = 0.82). Clavien–Dindo grade ≥ III complications occurred in 21 of 55 patients (38% versus 17%, P < 0.001). Median overall survival [95% confidence interval] was 15 [6.8–23.2] months. For patients with and without perioperative systemic therapy, median survival was 20 [12.3–27.7] and 10 [5.7–14.3] months, and for patients with pR0 and pR1 resection, it was 20 [11.8–28.3] and 5 [2.4–7.6] months, respectively. Conclusions: Gastrectomy with partial pancreatectomy is not only associated with a pR0 resection rate of 82% but also with increased postoperative morbidity. It should only be performed if a pR0 resection is feasible.",
keywords = "Gastrectomy, Gastric cancer, Multiviceral resection, Partial pancreatectomy, R0 resection",
author = "{van der Werf}, {L. R.} and Eshuis, {W. J.} and Draaisma, {W. A.} and {van Etten}, B. and Gisbertz, {S. S.} and {van der Harst}, E. and Liem, {M. S. L.} and Lemmens, {V. E. P. P.} and Wijnhoven, {B. P. L.} and Besselink, {M. G.} and {van Berge Henegouwen}, {M. I.} and {on behalf of the Dutch Upper Gastrointestinal Cancer Audit (DUCA) group.} and {van Hillegersberg}, R. and {van Eijden}, Y. and {van Esser}, S. and Hartgrink, {H. H.} and {de Jong}, G. and Karsten, {T. M.} and Kouwenhoven, {E. A.} and Lagarde, {S. M.} and Nieuwenhuijzen, {G. A. P.} and {van der Peet}, {D. L.} and {van Sandick}, {J. W.} and Talsma, {A. K.} and Tetteroo, {G. W. M.}",
note = "Funding Information: The authors would like to thank all surgeons, registrars, physician assistants, and administrative nurses for data registration in the DUCA database, the Dutch Upper GI Cancer Audit group for scientific input, as well as the following persons who have contributed to this study: R. van Hillegersberg, MD PhD, Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands Y. van Eijden, Department of Surgery, Zuyderland Hospital, Heerlen, the Netherlands S. van Esser, MD PhD, Department of Surgery, Reinier de Graaf Hospital, Delft, the Netherlands H. H. Hartgrink, MD PhD, Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands G. de Jong, MD PhD, Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands T. M. Karsten, MD PhD, Department of Surgery, Onze Lieve Vrouwe Hospital, Amsterdam, the Netherlands E. A. Kouwenhoven, MD PhD, Department of Surgery, Ziekenhuisgroep Twente, Almelo, the Netherlands S. M. Lagarde, MD PhD, Department of Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands G. A. P. Nieuwenhuijzen, MD PhD, Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands D. L. van der Peet, MD PhD, Department of Surgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands J. W. van Sandick, MD PhD, Department of Surgery, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands A. K. Talsma, MD PhD, Department of Surgery, Deventer Ziekenhuis, Deventer, the Netherlands G. W. M. Tetteroo, MD PhD, Department of Surgery, Ysselland Hospital, Rotterdam, the Netherlands Publisher Copyright: {\textcopyright} 2019, The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2019",
month = dec,
day = "1",
doi = "https://doi.org/10.1007/s11605-019-04133-z",
language = "English",
volume = "23",
pages = "2327--2337",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "12",
}