Prognostic value of adjacent organ resection in patients with left‐sided pancreatic ductal adenocarcinoma following distal pancreatectomy

Background We evaluated whether distal pancreatectomy (DP) with adjacent organ resection (AOR) affected perioperative outcomes and survival in patients with left‐sided pancreatic ductal adenocarcinoma (PDAC). Methods Retrospective cohort study was conducted at single large volume academic medical center from January 2000 to December 2016. Results Five hundred and twenty‐three patients had undergone standard DP (without additional vessel/organ resection) and 40 had undergone DP with AOR due to adjacent organ infiltration. There were no differences of postoperative morbidity and hospital stay between the two groups. In the patients with AJCC 8th stage I and II PDAC, there were significant differences of median disease‐specific and progression‐free survivals between the standard and AOR groups (37.9 vs. 20.2 months; P = 0.05, 20 vs. 10 months; P = 0.028, respectively). DP with AOR was identified as independent prognostic factor of stage I and II PDAC by multivariate Cox regression analysis. Conclusions Distal pancreatectomy with AOR could be an acceptable surgical treatment for left‐sided PDAC. However, AOR group shows poor prognosis than that of the standard group in patients with AJCC 8th stage I and II PDAC. AOR should be considered indicative of a more aggressive tumor in AJCC 8th stage I and II PDAC. Highlight Setting out to evaluate whether distal pancreatectomy with adjacent organ resection affects perioperative outcomes and survival in patients with left‐sided pancreatic ductal adenocarcinoma, Song and colleagues concluded that combined adjacent organ resection is a poor prognostic factor in patients with AJCC 8th Stage I and II left‐sided pancreatic ductal adenocarcinoma.