Removing left-sided pancreatic cancer through minimally invasive surgery is just as effective as a more invasive open procedure, and patients live just as long afterward. This is the conclusion of the large international DIPLOMA trial, conducted in 35 hospitals across 12 countries and coordinated by the Amsterdam UMC Cancer Center Amsterdam. The results have been published today in JAMA Surgery.
For patients with left-sided pancreatic cancer, surgical resection combined with chemotherapy is the best treatment. In the past, this was performed through a major open operation, but in recent years minimally invasive approaches have become increasingly common. This technique uses small incisions in the abdomen, allowing patients to recover more quickly.
Equally effective and save
Earlier findings had already shown that tumors on the left side of the pancreas were just as often completely removed at microscopic level with minimally invasive surgery as with open surgery. However, it was still unclear whether this method was equally effective in the long term and what impact it had on patient survival. After three years, results now show that this method is indeed as effective. Patients live just as long after minimally invasive surgery as after open surgery, and the administration of adjuvant chemotherapy was equally feasible.
Less pain and discomfort
Physician-researcher Caró Bruna: “The first published results had already shown that patients recovered more quickly and that minimally invasive surgery was just as effective in removing the tumor as open surgery. After more than three years of follow-up, we can now also confirm that survival rates are the same in both groups. This is, of course, the outcome we had hoped for.”
Professor of surgery Marc Besselink: “For patients with left-sided pancreatic cancer, minimally invasive surgery is therefore a fully valid and safe option. This is important, as patients tend to recover more quickly and often experience less pain and discomfort during what is already a very difficult time.”
Professor Mohammad Abu Hilal, professor of surgery at the University of Southampton: “These results demonstrate that with modern, minimally invasive techniques we can make significant progress in the treatment of pancreatic cancer, without compromising safety or effectiveness.”
Next steps
Follow-up research is currently investigating whether minimally invasive surgery is also suitable for performing the more complex pancreatoduodenectomy, when the pancreatic head is removed due to cancer.