ArticleBMC surgery2026
Outcomes after gastrectomy plus pancreatic resection for gastric cancer invading the pancreas.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRadical resection is the primary treatment for resectable gastric cancer (GC). However, outcomes remain poor for patients requiring combined gastrectomy and pancreatic resection due to pancreatic invasion. This study compares surgical and survival outcomes between radical (R0) gastrectomy with pancreaticoduodenectomy (PD) versus distal pancreatectomy (DP).
methodsWe retrospectively analyzed 81 patients with pancreatic-invading GC who underwent R0 gastrectomy with pancreatic resection (January 1994-June 2023). Demographics, surgical complications, adjuvant chemotherapy, and survival outcomes were assessed (median follow-up: 13.4 months).
resultsAmong the cohort, 36 patients underwent gastrectomy with PD, and 45 underwent gastrectomy with DP. The DP group had significantly more total gastrectomies (88.9% vs. 36.1%, p < 0.0001), tumors localized to the upper stomach (p < 0.0001), and a higher metastatic-to-total lymph node ratio (0.30 vs. 0.15, p = 0.024). Postoperative pancreatic fistula occurred less frequently in the DP group (17.8% vs. 61.1%, p < 0.0001), correlating with a shorter median hospital stay (17 vs. 22 days, p = 0.045). Patient age, tumor characteristics, mortality, lymph node retrieval, and adjuvant chemotherapy use were comparable. Two-year disease-free survival (14.5% PD vs. 20.9% DP, p = 0.988) and cancer-specific survival rates (26.8% PD vs. 32.1% DP, p = 0.815) showed no differences. Multivariate analysis identified stage IIIC (reference: IIIA) as an independent prognostic factor for both disease-free survival (adjusted hazard ratio 3.91, p = 0.015) and cancer-specific survival (adjusted hazard ratio 3.12, p = 0.045).
conclusionsGastrectomy with PD or DP yields similarly poor outcomes for pancreatic-invading GC. Tumor stage (nodal status) is the dominant prognostic factor.
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