Survival Study: International Multicentric Pancreatic Left Resections (SIMPLR-2): Does Surgical Approach Matter for...

Introduction: SIMPLR-2 is a follow-up to the international, multicenter SIMPLR-1 study evaluating long-term oncological outcomes after open (OLP), laparoscopic (LLP), and robotic (RLP) left pancreatectomy for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective analysis of 71 PDAC patients from three high-volume centers was performed. Surgical approaches were stratified into open, laparoscopic, and robotic. The primary endpoint was overall survival (OS); recurrence-free survival (RFS) was also assessed. Kaplan-Meier and Cox regression analyses were used, including propensity score adjustment. Results: Median OS was 11.0 months for OLP and 24.0 months for minimally invasive approaches (p = 0.169). Median RFS was 6 vs. 15 months, respectively (p = 0.258). No significant differences were found between surgical approaches. Conclusions: Although longer survival was observed in minimally invasive groups, differences were not statistically significant. Larger prospective trials are needed to clarify the long-term oncologic impact of a surgical approach in PDAC.