Minimally invasive versus open distal pancreatectomy for pancreatic neuroendocrine tumors: An analysis from the U.S. neuroendocrine tumor study group. Journal of surgical oncology Zhang, X., Lopez-Aguiar, A. G., Poultsides, G., Makris, E., Rocha, F., Kanji, Z., Weber, S., Fields, R., Krasnick, B. A., Idrees, K., Smith, P. M., Cho, C., Schmidt, C. R., Maithel, S. K., Pawlik, T. M., United States Neuroendocrine Tumor Study Group 2019


BACKGROUND: To determine short- and long-term oncologic outcomes after minimally invasive distal pancreatectomy (MIDP) with open distal pancreatectomy (ODP) for the treatment of pancreatic neuroendocrine tumor (pNET).METHODS: The data of the patients who underwent curative MIDP or ODP for pNET between 2000 and 2016 were collected from a multi-institutional database. Propensity score matching (PSM) was used to generate 1:1 matched patients with MIDP and ODP.RESULTS: A total of 576 patients undergoing curative DP for pNET were included. Two hundred and fourteen (37.2%) patients underwent MIDP, whereas 362 (62.8%) underwent ODP. MIDP was increasingly performed over time (2000-2004: 9.3% vs 2013-2016: 54.8%; P<0.01). In the matched cohort (n=141 in each group), patients who underwent MIDP had less blood loss (median, 100 vs 200mL, P<0.001), lower incidence of Clavien-Dindo=III complications (12.1% vs 24.8%, P=0.026), and a shorter hospital stay versus ODP (median, 4 versus 7 days, P=0.026). Patients who underwent MIDP had a lower incidence of recurrence (5-year cumulative recurrence, 10.1% vs 31.1%, P<0.001), yet equivalent overall survival (OS) rate (5-year OS, 92.1% vs 90.9%, P=0.550) compared with patients who underwent OPD.CONCLUSION: Patients undergoing MIDP over ODP in the treatment of pNET had comparable oncologic surgical metrics, as well as similar long-term OS.

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