Laparoscopic, Robotic Surgeries Equivalent for Pancreatic Cancer

DALLAS—Pancreatic cancer patients increasingly are receiving minimally invasive pancreaticoduodenectomy (MIPD), but, according to a new study, there is not yet enough research on whether robotic (RPD) or laparoscopic (LPD) procedures lead to better outcomes.

That’s according to a retrospective study published recently in the journal Surgical Endoscopy.  A study team of researchers from the VA North Texas Healthcare System and the University of Texas Southwestern Medical Center used the National Cancer Database between 2010 and 2013 to compare perioperative, pathological and mid-term oncological outcomes between RPD and LPD.1

The researchers focused on 1,623 MIPD cases—90% of them LPD and 10% RPD. They found that most LPD (63%) and RPD (51%) cases were performed at institutions with a volume of five or fewer MIPDs per year.

Results indicated no differences in patient- and tumor-related factors between the groups. The majority of treated tumors were adenocarcinoma (90.1% for RPD and 89.1% for LPD), according to the study.

RPDs were more likely to be performed at academic centers (89.1%) compared to LPDs (68.1%, P < 0.001) and at higher-volume centers (median MIPD/year of 4.7 for RPD vs 3.6 for LPD, P < 0.001), study authors reported. No difference was documented, however, in the median number of examined lymph nodes, margin status, median length of stay, 90-day mortality or 30-day re-admission between groups. Median overall survival for pancreatic adenocarcinoma between LPD (20.7 months) and RPD (22.7 months; log-rank P = 0.445) also wasn’t significant. In addition, the one and three-year overall survival rates were 74 and 31% for LPD vs. 71 and 33% for RPD.

“In this national cohort of patients, LPD and RPD were associated with equivalent perioperative, pathological, and mid-term oncological outcomes,” the study authors concluded.

  1. Nassour I, Choti MA, Porembka MR, Yopp AC, Wang SC, Polanco PM. Robotic-assisted versus laparoscopic pancreaticoduodenectomy: oncological outcomes. Surg Endosc. 2017 Dec 26. doi: 10.1007/s00464-017-6002-2. [Epub ahead of print] PubMed PMID: 29280014.

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