Outcomes of Total Pancreatectomy Versus Pancreaticoduodenectomy for Surgical Management of Pancreatic Ductal Adenocarcinoma

Document Type

Article

Publication Date

4-8-2026

Publication Title

Journal of Surgical Oncology

Abstract

BACKGROUND: Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Surgical resection provides the highest chance of improved survival. This study investigates the role of total pancreatectomy (TP) in the surgical management of PDAC based on clinicopathologic characteristics and the effect these factors have on patients' outcomes. METHODS: Data from the National Cancer Database for patients undergoing TP or pancreaticoduodenectomy (PD) was analyzed. Statistical tests included Chi-square test, logistic regression, least squared means, and Cox proportional hazard model to determine frequency and percentage, odds ratios, and hazard ratio, respectively. RESULTS: Of patients receiving PDAC resection, more TP patients were uninsured. Tumors in the pancreatic body or an overlapping locations increase the odds of receiving TP. Most statistically significant differences in clinicopathologic characteristics between the groups were not clinically meaningful. Despite a slight increase in short-term mortality for stage 2 patients receiving a TP, there was no clinically meaningful difference in overall survival. CONCLUSION: TP conferred a minimally worsened short-term survival for stage 2 PDAC, but oncologic outcomes and OS were similar for TP and PD. Therefore, surgical approach should be guided by individual patient characteristics and comorbidities, as long-term oncologic outcomes between the two procedures are comparable.

First Page

1

Last Page

10

PubMed ID

41947589

Rights

© 2026 Wiley Periodicals LLC

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