TRIANGLE operation,combined with adequate adjuvant chemotherapy,can improve the prognosis of pancreatic head cancer:A retrospective study  

作　　者：Jia-Hao Chen Li-Yong Zhu Zhi-Wei Cai Xiao Hu Abousalam Abdoulkader Ahmed Jie-Qiong Ge Xiao-Yan Tang Chun-Jing Li Yun-Long Pu Chong-Yi Jiang 

机构地区：[1]Department of Hepato-Biliary-Pancreatic Surgery,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China [2]Shanghai Key Laboratory of Clinical Geriatric Medicine,Fudan University,Shanghai 200040,China [3]Department of Nursing,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第5期1773-1786,共14页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by Shanghai Science and Technology Commission of Shanghai Municipality,No.20Y11908600;Shanghai Municipal Health Commission,No.20194Y0195;Medical Engineering Jiont Fund of Fudan University,No.XM03231533.

摘　　要：BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve patient prognosis.Although previously promising in patients with locally advanced pancreatic ductal adenocarcinoma(PDAC),data are limited regarding the long-term oncological outcomes of the TRIANGLE operation among resectable PDAC patients undergoing pancreaticoduodenectomy(PD).AIM To evaluate the safety of the TRIANGLE operation during PD and the prognosis in patients with resectable PDAC.METHODS This retrospective cohort study included patients who underwent PD for pancreatic head cancer between January 2017 and April 2023,with or without the TRIANGLE operation.Patients were divided into the PD_(TRIANGLE)and PD_(non-TRIANGLE)groups.Surgical and survival outcomes were compared between the two groups.Adequate adjuvant chemotherapy was defined as adjuvant chemotherapy≥6 months.RESULTS The PD_(TRIANGLE)and PD_(non-TRIANGLE) groups included 52 and 55 patients,respectively.There were no significant differences in the baseline characteristics or perioperative indexes between the two groups.Furthermore,the recurrence rate was lower in the PD_(TRIANGLE) group than in the PD_(non-TRIANGLE) group(48.1%vs 81.8%,P<0.001),and the local recurrence rate of PDAC decreased from 37.8%to 16.0%.Multivariate Cox regression analysis revealed that PD_(TRIANGLE)(HR=0.424;95%CI:0.256-0.702;P=0.001),adequate adjuvant chemotherapy≥6 months(HR=0.370;95%CI:0.222-0.618;P<0.001)and margin status(HR=2.255;95%CI:1.252-4.064;P=0.007)were found to be independent factors for the recurrence rate.CONCLUSION The TRIANGLE operation is safe for PDAC patients undergoing PD.Moreover,it reduces the local recurrence rate of PDAC and may improve survival in patients who receive adequate adjuvant chemotherapy.

关 键 词：TRIANGLE operation Pancreatic ductal adenocarcinoma Heidelberg triangle Adjuvant chemotherapy PROGNOSIS PANCREATICODUODENECTOMY 

分 类 号：R735.9[医药卫生—肿瘤]