ASCO: Minimally Invasive Noninferior to Open Surgery for Pancreatic Cancer

Radical resection occurred in 73 percent undergoing minimally invasive surgery, 69 percent undergoing open distal pancreatectomy

For patients with resectable pancreatic cancer, minimally invasive distal pancreatectomy (MIDP) is noninferior to open distal pancreatectomy (ODP), according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

Mohammed Abu Hilal, M.D., Ph.D., from the Instituto Ospedaliero Fondazione Poliambulanza in Brescia, Italy, and colleagues conducted a noninferiority trial involving patients with resectable pancreatic cancer from 35 centers in 12 countries. Participants were randomly assigned to MIDP (laparoscopic or robotic) or ODP (131 and 127 patients, respectively).

The modified intention-to-treat analysis population included 117 in the MIDP group and 114 patients in the ODP group. The researchers found that a radical resection (R0, <1 mm free margin) occurred in 73 and 69 percent of patients in the MIDP and ODP groups, respectively (difference, 4 percent). The groups had a comparable median lymph node yield (22.0 and 23.0 nodes for MIDP and ODP, respectively) and a similar rate of intraperitoneal recurrence (41 and 38 percent for MIDP and ODP, respectively). Other postoperative outcomes were also similar in the groups.

“For pancreatic cancer, we have proven for the first time that minimally invasive distal pancreatectomy is as good as open surgery,” Abu Hilal said in a statement. “Our research provides reassurance for surgeons and can help patients by giving them the information they need to have a conversation with their doctor about how they want to be treated.”

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