Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis.

Simple Summary: Our study aimed to compare the operative and survival outcomes between radical antegrade modular pancreatosplenectomy (RAMPS) and conventional distal pancreatosplenctomy (cDPS), and identify prognostic factors for left-sided pancreatic cancer. We performed a retrospective propensity score match (PSM) analysis from 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer. After PSM, 99 cohorts were matched in each group. We compared survival and operative outcomes and assessed prognostic factors. R0 resection rate was similar between both groups, and R1 resection rate was a significant prognostic factor. RAMPS was found to be safe, feasible, and to improve the number of retrieved lymph nodes. However, when R0 resection was similar in both groups, RAMPS was not associated with improved survival. Adjuvant treatment was a significant independent prognostic factor for overall and disease-free survival, but operation type was not. (1) Background: The aim of this study was to compare the survival benefit of radical antegrade modular pancreatosplenectomy (RAMPS) with conventional distal pancreatosplenectomy (cDPS) in left-sided pancreatic cancer. (2) Methods: A retrospective propensity score matching (PSM) analysis was conducted on 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer at four tertiary cancer centers. The study assessed prognostic factors and compared survival and operative outcomes. (3) Results: After PSM, 99 patients were matched in each group. RAMPS resulted in a higher retrieved lymph node count than cDPS (15.0 vs. 10.0, p < 0.001). No significant differences were observed between the two groups in terms of R0 resection rate, blood loss, hospital stay, or morbidity. The 5-year overall survival rate was similar in both groups (cDPS vs. RAMPS, 44.4% vs. 45.2%, p = 0.853), and disease-free survival was also comparable. Multivariate analysis revealed that ASA score, preoperative CA19-9, histologic differentiation, R1 resection, adjuvant treatment, and lymphovascular invasion were significant prognostic factors for overall survival. Preoperative CA19-9, histologic differentiation, T-stage, adjuvant treatment, and lymphovascular invasion were independent significant prognostic factors for disease-free survival. (4) Conclusions: Although RAMPS resulted in a higher retrieved lymph node count, survival outcomes were not different between the two groups. RAMPS was a surgical option to achieve R0 resection rather than a standard procedure. [ABSTRACT FROM AUTHOR]

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