238P - Three-dimensional remnant pancreatic volumetry predicts the short-term outcomes of pancreatic cancer patients after pancreatoduodenectomy (238P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Pancreatic Cancer
Gastrointestinal Cancers
Imaging, Diagnosis and Staging
Presenter Ryoichi Miyamoto
Citation Annals of Oncology (2017) 28 (suppl_10): x57-x76. 10.1093/annonc/mdx660
Authors R. Miyamoto, N. Sano, S. Tadano, S. Inagawa
  • Department Of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 305-8558 - Tsukuba/JP

Abstract

Background

Pancreatoduodenectomy (PD) is the standard operative procedure for the pancreatic head cancer. Recent improvements in operative techniques and perioperative management have decreased the postoperative mortality rates substantially to less than 5%. Nevertheless, postoperative morbidity remains high with approximately 30%. In particular, postoperative pancreatic fistula (POPF) was known to be one of the serious complications after PD. Recent studies suggested that remnant pancreatic volume (RPV) from preoperative multi-detector computed tomography (MDCT) was highly predictive of POPF. We performed three-dimensional (3D) surgical simulation of PD including measurement of the RPV. The aim of this study was to determine whether the 3D-measured RPV is a predictive value of short-term outcomes including POPF of pancreatic cancer patients after PD.

Methods

We used the SYNAPSE VINCENT® medical imaging system (Fujifilm Medical Co., Ltd., Tokyo, Japan) to construct 3D images from integrating MDCT and magnetic Resonance cholangiopancreatography (MRCP) images. The PRV was measured by this 3D image which simulated actual intraoperative pancreatic parenchymal remnant volume. Ninety-one patients who underwent PD were retrospectively enrolled. We divided the cohort into high- and low-RPV groups based on receiver operating characteristic curve analysis cut-off values (> 31.5cm3, n = 33 and ≤ 31.5cm3, n = 58, respectively). The patient characteristics and perioperative outcomes were respectively compared between the two groups.

Results

Significant differences were observed in Grades B and C POPF (15 [45.4%] vs. 6 [10.3%], p 

Conclusions

The present study indicated that the high-RPV influenced short-term outcomes. The preoperative 3D-measured RPV is a useful predictive value of short-term outcomes of pancreatic cancer patients after PD.

Clinical trial identification

Legal entity responsible for the study

The ethics committee of the Tsukuba Medical Center Hospital approved this study.

Funding

None

Disclosure

All authors have declared no conflicts of interest.