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. Clinical Outcome of RAMPS for Left-Sided Pancreatic Ductal Adenocarcinoma: A Comparison of Anterior RAMPS Versus Posterior RAMPS for Patients without Periadrenal Infiltration

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Abstract
Radical antegrade modular pancreatosplenectomy (RAMPS) is considered an effective
procedure for left-sided pancreatic ductal adenocarcinoma (PDAC). However, whether there are
differences in perioperative outcomes, pathologies, or survival outcomes between anterior RAMPS
(aRAMPS) and posterior RAMPS (pRAMPS) has not been reported previously. We retrospectively
reviewed and compared the demographic, perioperative, histopathologic, and survival data of patients who underwent aRAMPS or pRAMPS for PDAC. We also compared these two groups among
patients without periadrenal infiltration or adrenal invasion. A total of 112 aRAMPS patients and
224 pRAMPS patients were evaluated. Periadrenal infiltration, neoadjuvant treatment, and concurrent vessel resection were more prevalent in the pRAMPS group. After excluding patients with periadrenal infiltration, 106 aRAMPS patients were compared with 157 pRAMPS patients. There were
no significant differences between the aRAMPS and pRAMPS groups in the pathologic tumor size,
resection margin, proportion of tangential margin in the R1 resection, and number of harvested
lymph nodes. The median overall survival and disease-free survival also did not differ significantly
between the two groups. We cautiously suggest that pRAMPS will not necessarily provide more
beneficial histopathologic outcomes and survival rates for left-sided PDAC cases without periadrenal infiltration. If periadrenal infiltration is not suspected, aRAMPS alone should be sufficiently
effective.
Author(s)
권재우박예종전은성이우형송기병이재훈황대욱김송철
Issued Date
2021
Type
Article
Keyword
RAMPSadrenalectomydistal pancreatectomypancreatic cancer
DOI
10.3390/biomedicines9101291
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8196
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_a3a5f4c4d6114e93ba70feb908e7af85&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,.%20Clinical%20Outcome%20of%20RAMPS%20for%20Left-Sided%20Pancreatic%20Ductal%20Adenocarcinoma:%20A%20Comparison%20of%20Anterior%20RAMPS%20Versus%20Posterior%20RAMPS%20for%20Patients%20without%20Periadrenal%20Infiltration&offset=0&pcAvailability=true
Publisher
Biomedicines
Location
미국
Language
영어
ISSN
2227-9059
Citation Volume
9
Citation Number
10
Citation Start Page
1291
Citation End Page
1305
Appears in Collections:
Medicine > Medicine
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