ReviewAnnals of surgical oncology2021
An Aggressive Approach to Locally Confined Pancreatic Cancer: Defining Surgical and Oncologic Outcomes Unique to Pancreatectomy with Celiac Axis Resection (DP-CAR).
Review in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Incidence and risk factors for Chyle leak after pancreatic surgery for cancer: A comprehensive systematic review.European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2022Pooled it
- The Progress of Pancreatectomy for Pancreatic Cancer Treatment-Lessons Learned and Future Challenges.Cancers · 2026Review
- Outcomes after surgery for locally advanced pancreatic cancer compared to borderline and upfront resectable pancreatic cancer.Hepatobiliary surgery and nutrition · 2026Article
- Distal and Total Pancreatectomy With En Bloc Celiac Axis Resection for Pancreatic Cancer at a High-Volume Center.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Real-world short-term outcomes after distal pancreatectomy with en bloc celiac axis resection using the National clinical database of Japan.Surgery today · 2026Article
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- Article
- Successful treatment for pseudoaneurysm following distal pancreatectomy with celiac axis resection without postoperative pancreatic fistula: a case report.Surgical case reports · 2024Article
- Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2024Review
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- Pancreatectomy with arterial resection for periampullary cancer: outcomes after planned or unplanned events in a nationwide, multicentre cohort.The British journal of surgery · 2023Article
- Article
- Pancreatectomy After Neoadjuvant FOLFIRINOX Chemotherapy: Identifying Factors Predicting Long-Term Survival.World journal of surgery · 2023Article
- Technical options in surgery for artery-involving pancreatic cancer: Invasion depth matters.Surgery open science · 2023Article
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- Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma.International journal of surgery case reports · 2022Article
- Precision Medicine in Pancreatic Cancer: Patient-Derived Organoid Pharmacotyping Is a Predictive Biomarker of Clinical Treatment Response.Clinical cancer research : an official journal of the American Association for Cancer Research · 2022Article
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- Anatomic Criteria Determine Resectability in Locally Advanced Pancreatic Cancer.Annals of surgical oncology · 2022Article
- Selecting surgical candidates with locally advanced pancreatic cancer: a review for modern pancreatology.Journal of gastrointestinal oncology · 2021Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundModern chemotherapeutics have led to improved systemic disease control for patients with locally advanced pancreatic cancer (LAPC). Surgical strategies such as distal pancreatectomy with celiac axis resection (DP-CAR) are increasingly entertained. Herein we review procedure-specific outcomes and assess biologic rationale for DP-CAR.
methodsA prospectively maintained single-institution database of all pancreatectomies was queried for patients undergoing DP-CAR. We excluded all patients for whom complete data were not available and those who were not treated with contemporary multi-agent therapy. Data were supplemented with dedicated chart review and outreach for long-term oncologic outcomes.
resultsFifty-four patients underwent DP-CAR between 2008 and 2018. The median age was 62.7 years. Ninety-eight percent received induction chemotherapy. Arterial reconstruction was performed in 17% and concomitant visceral resection in 30%. The R0 resection rate was 87%. Postoperative complications were common (43%) with chyle leak being the most frequent (17%). Length of stay was 8 days, readmission occurred in one-third, and 90-day mortality was 2%. Disease recurrence occurred in 74% during a median follow up of 17.4 months. Median recurrence-free (RFS) and overall survival (OS) were 9 and 25 months, respectively.
conclusionsFollowing modern induction paradigms, DP-CAR can be performed with low mortality, manageable morbidity, and excellent rates of margin-negative resection in high-volume settings. The profile of complications of DP-CAR is distinct from pancreaticoduodenectomy and simple distal pancreatectomy. OS and RFS are similar to those undergoing resection of borderline resectable and resectable disease. Improved systemic disease control will likely lead to increasing utilization of aggressive surgical approaches to LAPC.
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