1.
MIPD vs. OPD for pancreatic head cancer: safety, feasibility and outcomes (2017−2018)
| References | Ref (24) | Ref (25) | Ref (26) | Ref (27) | Ref (28) | Ref (29) | Ref (30) | Ref (31) | Ref (32) | Ref (33) | Ref (34) |
MIPD, minimally invasive pancreaticoduodenectomy; OPD, open pancreaticoduodenectomy; BMI, body mass index; ASA, American Society of Anesthesiologists; AJCC, American Joint Committee on cancer; EBL, estimated blood loss; PDAC, pancreatic ductal adenocarcinoma; POPF (B/C), grade B and C postoperative pancreatic fistula; LOS, length of stay; LPD, laparoscopic pancreaticoduodenectomy; RPD, robotic pancreaticoduodenectomy; NCDB, American National Cancer Database. Outcomes are
or median (range); *, P<0.05.
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| Country | USA | USA | USA | Europe | Italy | China | China | China | USA | USA | China |
| Procedures | OPD vs. MIPD (LPD+RPD) | OPD vs. LPD | RAPD vs. OPD (other journals) | OPD vs. MIPD (LPD+RPD) | OPD vs. RPD | RPD | LPD | OPD vs. LPD | OPD vs. LPD | OPD vs. RPD | LPD |
| Publication date | 2019 | 2018 | 2018 | 2018 | 2018 | 2018 | 2018 | 2018 | 2017 | 2017 | 2017 |
| Inclusion period | 2010−2015 | 2010−2013 | 2008−2014 | OPD: 2014−2017; MIPD: 2012−2017 | 2007−2014 | 2011−2017 | 2013−2017 | 2014−2016 | 2010−2013 | OPD: 2003−2015; RPD: 2011−2015 | 2012−2016 |
| Single/multiple centers | Multiple, NCDB | Multiple, NCDB | Multiple | Multiple | Single | Single | Single | Single | multiple, NCDB | OPD: multiple, 16 centers; RPD: single | Single |
| Type of study | Retrospective, propensity weighting | Retrospective | Retrospective | Retrospective propensity score-matched cohort study | Retrospective | Retrospective | Retrospective | Retrospective | Retrospective | Retrospective propensity score-matched cohort study | Retrospective |
| Patient number | 18,259 vs. 3,754 | 1,520 vs. 248 | 92 vs. 1,105 | 729 vs. 729 | 227 vs. 82 | 417 | 300 | 213 vs. 202 | 7,385 vs. 828 | 152 vs. 152 | 233 |
| Female | 48.22% vs. 48.32% | 53.6% vs. 46.8% | 53% vs. 41%−50% | 49.8% vs. 49.0% | 55.1% vs. 43.9% | 52% | 39% | 40.8% vs. 42.6% | − | 48.5% | 38% |
| Age (year) | >60, 69.48%vs. 69.40% | >75, 100%, 79.6vs. 79.5 | 65 vs. 66−69 | 64.6±11.7 vs. 64.5±11.6 | 67.4 (59.7−74.8)vs. 61.6 (51.9−70.7)* | 53.99±14.04 | 59.5±9.6 | 55±11 vs. 54±12 | 65.7±10.4 vs. 65.9±10.7 | 64 (56−72) | 60.3±13.0 |
| BMI (kg/m2) | − | − | 25.8 vs. 21.5−23.7 | 24.8±4.0 vs. 24.9±4.2 | 24.8±0.2 vs. 23.5±0.4* | 22.7±4.7 | 23.2±3.3 | 22±5 vs. 23±5 | − | − | 22.8±3.5 |
| ASA classification | − | − | >III, 46%vs. 16%−20% | >3, 20.4%vs. 22.2% | >II, 65.6%vs. 41.5%* | − | − | >II, 18.8%vs. 21.8% | − | − | − |
| Tumor size (mm) | 33.3±18.0 vs. 33.3±17.7 | >4 cm, 21.6%vs. 19.8% | − | 29.9±18.5 vs. 25.9±13.9 | − | − | 33 | − | − | − | 39±24 |
| AJCC stage 1+2 | 92.98% vs. 93.16% | 86.8% vs. 92.2% | − | T3−T4: 53%vs. 40%; N1−N2: 59.3%vs. 45.3% | − | − | − | − | 89.9% vs. 100% | − | − |
| Operative time (min) | − | − | 504 vs. (346−595) | 324.2±93.9 vs. 415.8±110.9 | 450 (370−520)vs. 502 (450−566)* | 300 (120−720) | 402 (150−720) | 320±91 vs. 301±175 | − | − | 368.0±57.4 |
| EBL (mL) | − | − | 242 vs. (500−1,340) | − | 782.4 (359.4−1,244.1)vs. 452.9 (183.6−713.9)* | 100 (20−2,000) | 500 (100−3,000) | 390±301 vs. 194±107 | − | − | 203.8±138.6 |
| Tumor type | Pancreatic cancer | Pancreatic cancer | Multiple | Pancreatic tumors, 62.1% vs. 62.8% | Multiple | Multiple | Multiple | Multiple | Pancreatic cancer | Multiple | Multiple |
| PDAC | 100% | 100% | 26% vs. 43%−55% | 47.3% vs. 42.1% | 41.9% vs. 28.1%* | 31.80% | 23.00% | 33.3% vs. 11.4%* | 100% | Cancer + pancreatitis, 53.3% vs. 53.3% | 36.00% |
| R0 rate | 80.0% vs. 84.6% | 73.0% vs. 77.4% | − | − | − | 97% | 99% | 97.2% vs. 99.0% | 76.8% vs. 79.1% | − | 99% |
| Resected lymph nodes | >16, 45.2%vs. 48.1% | >10, 67.8%vs. 69.0% | − | − | − | 14.9±6.7 | 13 | 10±5 vs. 10±5 | 17.1±9.6 vs. 18.1±9.5* | − | 21.3±11.9 |
| POPF (B/C) | − | − | 9.8% vs. 9.6%−17.8% | 12.7% vs. 22.6%* | 15.0% vs. 23.2% | 9.35% | 8.30% | 3.8% vs. 4.5% | − | 11.2% vs. 6.6% | 6.90% |
| Major morbidity | − | − | − | 30% vs. 28% | 13.7% vs. 11.0% | 13.20% | − | 32.9% vs. 30.2% | − | 23.7% vs. 23% | − |
| Mortality | 90-day, 6.69% vs. 5.02%; 30-day, 3.69% vs. 3.29% | 90-day, 12.2% vs. 7.2%*; 30-day, 5.9% vs. 4.9% | 2.2% vs. 1.0%−3.5% | 3.3% vs. 4.0% | 6.2% vs. 3.7% | 90-day, 1.61%; 30-day, 0.96% | 4.30% | 1.4% vs. 0.5% | 90-day: 7.3% vs. 6.9%; 30-day: 3.8% vs. 4.1% | 90-day: 1.3% vs. 3.3% | 0.90% |
| Survival time (month) | − | 15.6 vs. 19.8* | − | − | − | − | − | − | − | − | − |
| LOS (d) | >9, 43.8%vs. 35.1%* | 10 vs. 10 | 10 vs. (7−22) | 17.4±14.6 vs. 17.0±12.3 | 18 (14−28)vs. 18 (14−26) | − | 17 (6−89) | 19.2±7.1 vs. 13.0±7.2* | 11.8±9.3 vs. 10.2±8.5* | 11.8±10.6 vs. 10.5±6.9 | 18.1±11.2 |
| Readmission | 30-day: 8.04% vs. 8.2% | 13.1% vs. 9.7% | − | 12.6% vs. 9.8% | − | − | − | − | 9.2% vs. 6.8%* | 21.7% vs. 22.4% | − |
| Neoadjuvant chemotherapy | 15.07% vs. 15.22% | 9.7% vs. 6.6% | − | − | − | − | − | − | 12.7% vs. 12.6% | − | − |
| Neoadjuvant radiation | 7.43% vs. 7.61% | 3.9% vs. 5.7% | − | − | − | − | − | − | 7.2% vs. 6.7% | − | − |
| Adjuvant therapy | 56.1% vs. 57.6% | 36% vs. 35.9% | − | − | − | − | − | − | 60.4% vs. 61.4% | − | − |
| Conversion rate | − | 29.80% | − | 15.80% | 1.20% | 4.56% | − | − | − | − | − |
| Annual case volume >10 | 61.4% vs. 64.4% | 9.1% vs. 22.2%* | − | 100% | Yes | Yes | Yes | Yes | LPD≥20, 25% | − | Yes |