P-245 Survival after minimally invasive vs open surgery for pancreatic adenocarcinoma

Only a few high-volume centers have reported on long-term oncologic outcomes after minimally invasive pancreatic surgery (MIPS) for adenocarcinoma, but none of them shown superior overall survival (OS) compared with open (OPS). This comparative effectiveness study used retrospective analysis prospectively maintained electronic database patient data collected between January 2010 and December 2019. Consecutive patients from cancer referral center were included. Data was conducted March to October 2022. Median follow-up time 56.8 months. Patients matched using propensity score models survival. Survival analyzed the Cox proportional hazards model. Variables correction TNM stage, tumor dimension, lymph node status, type operation, simultaneous vascular resection, neoadjuvant chemotherapy, adjuvant sex, age, American Society Anesthesiologists score. Additional corrections made year chemotherapy. After matching sample 396 patients, there 198 in MIPS group (89 [44.9%] men; median [range] 68 [32-87] years) OPS (94 [47.5%] 67 [39-84] years). OS 30.7 (95% CI, 26.2-36.8) months 20.3 17.6-23.5) (hazard ratio [HR], 0.70; 95% 0.56-0.87; P = .002). disease-free (DFS) vs 14.8 11.8-17.0) 10.7 9.0-12.1) (HR, 0.71; 0.57-0.89; .003). chemotherapy showed better (year surgery: HR, 0.74; 0.57-0.96; .02; chemotherapy: 0.56-0.90; .005) DFS 0.77; 0.59-0.99; .04; 0.72; 0.57-0.92; .009) undergoing surgery. In this borderline resectable associated than OPS. Centralization should be stimulated, surgeons encouraged pass learning curve before implementing adenocarcinoma daily clinical practice.