For a study, researchers sought to develop a prospective randomised clinical study, it was doubtful that the effects of lymph node dissection and parenchyma-sparing resections (PSR) would be investigated in small (3 cm) non functional pancreatic neuroendocrine tumours (PNET). By merging information from 4 high-volume pancreatic institutions, they were able to compare the postoperative and long-term outcomes of PSR patients with those of patients who underwent oncologic resections. About 4 high-volume institutes provided retrospective reviews of clinicopathologic data that had been obtained prospectively on patients who had pancreatectomy operations between 2000 and 2021. Enucleation and central pancreatectomy patients who underwent PSR and lymph node-sparing resections were contrasted with those who underwent oncologic resections with lymphadenectomy (pancreaticoduodenectomy, distal pancreatectomy). The Kaplan-Meier method was used to estimate survival rates, the X2 test and the t test were used for statistical testing, and the Cox proportional hazard model was used for multivariate analysis. About 810 patients with tiny, sporadic PNETs that were not functional underwent oncologic resections in 589 patients (72.7%), 121 (14.9%) had enucleations, and 100 (12.3%) had central pancreatectomies. Median tumor size of 2.5 cm was seen, and the median age was 59.2% female. Around 221 patients were picked from each group after case-control matching for tumor size. In comparison to patients receiving oncologic resections, patients with PSR had higher rates of minimally invasive procedures (32.6% vs 13.6%, P<0.001), less intraoperative blood loss (358 vs 511 ml, P<0.001), and shorter operations (180 vs 330 minutes, P<0.001). Although PSR extracted less lymph nodes on average (n=1.4 vs n=9.9, P<0.001), there was still a significant difference. In comparison to patients who underwent lymphadenectomies, decreased postoperative complication rates (39.7% vs. 56.9%, P=0.008). Patients who underwent lymphadenectomy but had no lymph nodes removed experienced identical median disease-free survival (197.1 vs 191.9 months, P=0.837) and overall survival (200 vs 195.1 months, P=0.827) rates. PSRs and lymph node-sparing resections, when compared to oncologic resections, were associated with lesser blood loss, quicker operating times, and lower complication rates in small, nonfunctional PNETs (3 cm), and they also produce identical long-term oncologic results.

 

Source: journals.lww.com/annalsofsurgery/Abstract/2022/09000/Long_term_Outcomes_of_Parenchyma_sparing_and.12.aspx