Oncologic multivisceral resections involving the pancreas.

Rebelo, A.; Andersson, B.; Bandyopadhyay, SK.; Bereza-Carlson, P.; Berrevoet, F.; Bjornsson, B.; Bouwense, S.; Bosch, F.; Buchler, M.; Chatzizacharias, N.; Coubeau, L.; Crede, M.; Don, CBP.; Dries, P.; Felsenstein, M.; Frigerio, I.; Giardino, A.; Glowka, T.; Hadesi, P.; Hartman, V.; Johansen, K.; Klein, M.; Klose, J.; Knipper, K.; Leonhardt, CS.; Loos, M.; Malinka, T.; Marchegiani, G.; Mansson, C.; Pellegrini, R.; Perri, G.; Poelsler, L.; Roeyen, G.; Rousek, M.; Sancho, P.; Schild-Suhren, S.; Schmidt, T.; Serrablo, L.; Serrablo, A.; Smith, AM.; Stavrou, GA.; Strobel, O.; Strobel, A.; Tarantino, I.; Urdzik, J.; Vilz, T.; Vella, R.; Wennerblom, J.; Wyzlic, P.; Kleeff, J.

Oncologic multivisceral resections involving the pancreas.

All Authors

Rebelo, A.

Andersson, B.

Bandyopadhyay, SK.

Bereza-Carlson, P.

Berrevoet, F.

Bjornsson, B.

Bouwense, S.

Bosch, F.

Buchler, M.

Chatzizacharias, N.

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LTHT Author

Smith, Andrew Malvern

LTHT Department

Abdominal Medicine & Surgery

Publication Date

2025

Item Type

Journal Article

Abstract

OBJECTIVE: To evaluate short-term outcomes and identify predictors of morbidity and mortality following multivisceral oncologic resections involving the pancreas. SUMMARY BACKGROUND DATA: Multivisceral resections including the pancreas are required for locally advanced abdominal malignancies but are associated with considerable perioperative risk. While smaller series suggest acceptable outcomes in selected patients, large-scale international data are lacking to guide surgical decision-making and risk stratification. METHODS: This was a retrospective cohort study of 1,283 patients from 31 international centers who underwent multivisceral oncologic resections involving the pancreas. Patient demographics, tumor characteristics, operative details, and 90-day postoperative outcomes were analyzed. RESULTS: The cohort had a mean age of 64.7 years, and 54.7% were male. Distal pancreatectomy was the most frequent procedure (60.5%), and R0 resection was achieved in 60.9% of cases. Ninety-day mortality was 6.9%, highest in patients with gastric adenocarcinoma (16.7%). Major complications (Clavien-Dindo grade III-V) occurred in 34.4% of patients. Higher ASA classification and open surgical approach were independently associated with increased morbidity and mortality. Prolonged operative time was associated with morbidity only. Female gender and treatment at high-volume centers were protective. In patients with pancreatic tumors, resection involving the colon (OR 1.78, p<0.001), stomach (OR 1.33, p = 0.042), or three or more organs (OR 1.75, p = 0.006) significantly increased complication rates. CONCLUSIONS: Multivisceral resections involving the pancreas are associated with relevant perioperative risk. Optimizing patient selection, favoring minimally invasive techniques when feasible in selected patients, and centralizing care to high-volume centers may help improve outcomes for these complex surgical procedures.