4.
MIPD vs. OPD for pancreatic head cancer: oncological outcomes
| Reference | Ref (24) | Ref (25) | Ref (32) | Ref (35) | Ref (36) | Ref (40) | Ref (43) |
MIPD, minimally invasive pancreaticoduodenectomy; OPD, open pancreaticoduodenectomy; BMI, body mass index; ASA, American Society of Anesthesiologists; AJCC, American Joint Committee on cancer; LPD, laparoscopic pancreaticoduodenectomy; RPD, robotic pancreaticoduodenectomy; NCDB, American National Cancer Database. Outcomes are
or median (range); *, P<0.05.
| |||||||
| Country | USA | USA | USA | USA | USA | USA | USA |
| Procedures | OPD vs. MIPD (LPD+RPD) | OPD vs. LPD | OPD vs. LPD | OPD vs. MIPD (LPD+RPD) | OPD vs. LPD | OPD vs. LPD | OPD vs. LPD |
| Publication date | 2018 | 2018 | 2017 | 2016 | 2017 | 2015 | 2014 |
| Inclusion period | 2010−2015 | 2010−2013 | 2010−2013 | 2010−2012 | 1995−2014 | 2010−2011 | 2008−2013 |
| Single/multiple centers | multiple, NCDB | multiple, NCDB | multiple, NCDB | Multiple, NCDB | Single | Multiple, NCDB | Single |
| Type of study | Retrospective, propensity weighting | Retrospective | Retrospective | Retrospective | Retrospective | Retrospective | Retrospective |
| Patient number | 18,259 vs. 3,754 | 1,520 vs. 248 | 7,385 vs. 828 | 6,776 vs. 1,191 | 193 vs. 58 | 4,037 vs. 387 | 214 vs. 108 |
| Annual case volume >10 | 61.4% vs. 64.4% | 9.1% vs. 22.2%* | LPD ≥20, 25% | − | Yes | 30% | Yes |
| Female | 48.22% vs. 48.32% | 53.6% vs. 46.8% | − | 48.4% vs. 48.5% | 50.3% vs. 44.8% | − | 39% vs. 53%* |
| Age (year) | >60, 69.48%vs. 69.4% | >75, 100%, 79.6vs. 79.5 | 65.7±10.4 vs. 65.9±10.7 | 66.4 vs. 66.6 | 68.9 (33.3−86.9)vs. 69.9 (40.6−84.8) | 66±10 vs. 66±11 | 65±11 vs. 67±10 |
| BMI (kg/m2) | − | − | − | − | 25.6 (15.0−46.1)vs. 25.9 (17.7−49.6) | − | 27±5 vs. 27±5 |
| ASA classification | − | − | − | − | ≥3, 79.7% vs. 72.4%* | − | − |
| Tumor size (mm) | 33.3±18 vs. 33.3±17.7 | >4 cm, 21.6%vs. 19.8% | − | 33.6 vs. 33.7 | 35 (3−140)vs. 25 (3−100)* | 33±24 vs. 32±13 | 33±13 vs. 33±10 |
| AJCC stage 1+2 | 92.98% vs. 93.16 | 86.8% vs. 92.2% | 89.9% vs. 100% | 100% vs. 100% | 96.8% vs. 98.3% | 94% vs. 97% | − |
| R0 rate | 80% vs. 84.6% | 73% vs. 77.4% | 76.8% vs. 79.1% | 77.9% vs. 79.8% | 79.8% vs. 84.5% | 74% vs. 80% | 77% vs. 78% |
| Resected lymph nodes | >16, 45.2%vs. 48.1% | >10, 67.8%vs. 69% | 17.1±9.6 vs. 18.1±9.5* | 16.5±9.6 vs. 17.4±10.0* | 17 (1−63)vs. 27 (9−70)* | 16±10 vs. 18±10.0* | 20±8 vs. 21±8 |
| Neoadjuvant chemotherapy | 15.07% vs. 15.22% | 9.7% vs. 6.6% | 12.7% vs. 12.6% | 13.1% vs. 12.9% | − | 12% vs. 11% | 14.0% vs. 11.1% |
| Neoadjuvant radiation | 7.43% vs. 7.61% | 3.9% vs. 5.7% | 7.2% vs. 6.7% | − | − | 8% vs. 7% | − |
| Adjuvant therapy | 56.1% vs. 57.6% | 36.0% vs. 35.9% | 60.4% vs. 61.4% | 52.7% vs. 55.3% | 73.5% vs. 75.9% | − | 76% vs. 76% |
| Survival time (month) | − | 15.6 vs. 19.8* | − | − | 20.3 vs. 18.5 | − | 21.8 vs. 25.3 |