Evidence map›Paper›PMID 41233673›Full record

ArticleUpdates in surgery2026

Surgical management of pancreatic neck cancer: an ongoing dilemma.

Davide De Sio, Claudio Fiorillo, Lodovica Langellotti, Beatrice Biffoni, Chiara Lucinato, Fausto Rosa, Vincenzo Tondolo, Giuseppe Quero, Sergio Alfieri, Roberta Menghi

Abstract readComparative Study
In one paragraph

Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Davide De SioPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Claudio FiorilloPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Lodovica LangellottiPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Beatrice BiffoniPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Chiara LucinatoPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Fausto RosaPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Vincenzo TondoloUniversità Cattolica del Sacro Cuore Di Roma, Largo Francesco Vito 1, 00168, Rome, Italy.
Giuseppe QueroPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy. giuseppe.quero@policlinicogemelli.it.ORCID http://orcid.org/0000-0002-0001-9479
Sergio AlfieriPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.
Roberta MenghiPancreatic Surgery Unit, Department of Surgery, Gemelli Pancreatic Center, CRMPG (AdvancedPancreatic Research Center), Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The surgical management of pancreatic neck adenocarcinoma (neck PDAC) ranges from extended pancreaticoduodenectomy (ePD) to subtotal left pancreatectomy (sLP) and total pancreatectomy, with no clear consensus on the optimal approach. This study aimed to compare ePD and sLP in terms of perioperative and long-term outcomes. All patients who underwent ePD or sLP for neck PDAC were retrospectively reviewed and compared for perioperative and long-term outcomes. Forty-six patients were included: 18 (39.1%) underwent ePD and 28 (60.9%) sLP. ePD was associated with a higher rate of neoadjuvant treatment, longer operative time, and longer hospital stay. The most frequently involved lymph-node stations were #13-17 in the ePD group (44.4%) and #18 in the sLP group (42.9%). Overall survival (OS) was similar (p = 0.06), while disease-free survival (DFS) was longer in the sLP group (16 [9-22] vs 12 [5-18] months in the ePD group; p = 0.03). Due to the high rate of nodal metastases in station #13-17 and #18, both procedures may be inadequate as surgical treatment of neck PDAC. While sLP appears to offer better long-term outcomes, the heterogeneity of the study population limits generalizability. Larger prospective studies are needed to determine the most effective surgical approach.

Indexed as

AdenocarcinomaPancreatectomyPancreatic NeoplasmsPancreaticoduodenectomyAgedDisease-Free SurvivalFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoadjuvant TherapyOperative TimeRetrospective StudiesTreatment Outcome

Identifiers

PMID41233673
PMCPMC13212397

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.