Long-term survival analysis comparison of radical antegrade modular pancreatectomy (RAMPS) and standard retrograde pancreatectomy (SPRS): Based on LASSO Cox regression prediction model.

Abstract

e16437 Background: This study aims to evaluate the advantages of radical anterograde modular pancreatictomy (RAMPS) over standard retrograde pancreatictomy (SPRS) in disease-free survival (DFS) by comparing clinical outcomes. Methods: The clinical data of 154 patients who underwent distal pancreatectomy at the Cancer Institute and Hospital of Tianjin Medical University from January 2015 to August 2018 were collected. We compared preoperative conditions, postoperative complications, and survival outcomes in people who underwent two different procedures. By establishing the LASSO-Cox model, we determined the parameters that affect DFS and the risk ratios of the two procedures for DFS. Results: There were significant differences between the RAMPS group and the SPRS group in terms of R0 resection rate (85.23% vs. 68.18%, P = 0.003), negative resection rate (96.59% vs. 75.76%, P < 0.001) and tumor bed recurrence rate (15.29% vs. 40.00%, P = 0.001). The 1-, 3-, and 5-year survival rates and DFS rates in the RAMPS group were significantly better than those in the SPRS group (P < 0.05). Disease-free survival analysis based on Kaplan–Meier curve showed that RAMPS was superior to SPRS (P < 0.001). Conclusions: We recommend RAMPS as the procedure of choice for the treatment of pancreatic caudal ductal adenocarcinoma because of its enhanced lymph node repair capabilities and visualization of posterior pancreatic sections, prolonging the patient's DFS.