Locally Advanced Pancreatic Head Cancer: Margin-Positive Resection or Bypass?

Table 1

Patients, operations and pathology. 𝑃 value given for two-sided Kruskal-Wallis and Fisher’s exact test. Figures that cause a statistically significant difference are printed bold. R0/R+: pancreatoduodenectomy with free/positive resection margins, M0: absence of distant metastasis at laparotomy, M+: presence of distant or peritoneal metastasis at laparotomy, bypass: palliative bypass procedures, GE: gastroenterostomy, HE: hepaticoenterostomy, and double: GE and HE.

Parameter	Resection		Bypass	𝑃 value
	R0	R+
𝑁	172	71	117	—
Age (years, median)	66	65	67	0.211
Gender m : w	77 : 95	37 : 34	72 : 45	0.020
BMI (kg/m^2, median)	24	25	23	0.166
Neoadjuvant CRx	6/4%	8/11%	4/3%	0.046
PreOP biliary drainage	116/67%	37/52%	63/54%	0.022
Gastric outlet obstruction	16/9%	4/6%	40/34%	<0.001
Diabetes mellitus	41/24%	25/35%	34/29%	0.188
Creatinine (mg/dL, median)	0.7	0.8	0.7	0.705
Bilirubin (mg/dL, median)	1.6	1.1	1.4	0.337
Resection procedures	Whipple 23/13%; PPPD 149/87%	Whipple 14/20%; PPPD 57/80%	—	0.305
Bypass procedures	—	—	Double 79/68%; GE 30/26%; HE 8/7%	—
Portal venous resection	57/33%	34/48%	——	<0.001
OP Time (Min, median)	445	470	240	<0.001
pT4 tumors	6/4%	17/24%	—	<0.001
Lymph node positive	119/70%	55/79%	—	0.158
Distant metastasis	3/2%	3/4%	80/68%	<0.001