title: Single institution results of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of pancreas in 78 patients.
abstract: BACKGROUND
  The purpose of this report is to present results of the radical antegrade modular pancreatosplenectomy (RAMPS) procedure in 78 patients from a single center.
  
  
  METHODS
  Seventy-eight patients had RAMPS procedure over 13 years. A database dealing with RAMPS for adenocarcinoma of the pancreas was constructed so that it could be converted into a set of tables. Each table covered one element of the subject. The database was populated from clinical records of patients who had a RAMPS procedure from 1999 to 2013.
  
  
  RESULTS
  Fifty-six patients had anterior RAMPS and 22 had posterior RAMPS. Negative tangential margins were obtained in 94% of specimens. Overall the R0 rate was 85%. Mean lymph node count was 20. There were no 30-day or in-hospital mortalities but two patients died within 90 days. Pancreatic fistula and need for postoperative transfusion were the most common complications. Median survival was 24.6 months and 5-year overall actuarial survival was 25.1%.
  
  
  CONCLUSIONS
  The RAMPS technique resulted in high negative tangential margin rates and good lymph node retrieval. The long-term survival result in 78 patients is probably an accurate reflection of what is possible with this tumor using this technique at this time.
authors.affiliation: Section of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Washington University in St. Louis, Barnes-Jewish Hospital and Siteman Cancer Center, 4990 Children's Place, Suite 1160, Box 8109, St. Louis, MO, 63110, USA.
authors.forename: Julie G
authors.initials: JG
authors.lastname: Grossman
authors.affiliation: Section of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Washington University in St. Louis, Barnes-Jewish Hospital and Siteman Cancer Center, 4990 Children's Place, Suite 1160, Box 8109, St. Louis, MO, 63110, USA.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Fields
authors.affiliation: Section of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Washington University in St. Louis, Barnes-Jewish Hospital and Siteman Cancer Center, 4990 Children's Place, Suite 1160, Box 8109, St. Louis, MO, 63110, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Hawkins
authors.affiliation: Section of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Washington University in St. Louis, Barnes-Jewish Hospital and Siteman Cancer Center, 4990 Children's Place, Suite 1160, Box 8109, St. Louis, MO, 63110, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Strasberg
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D061646:Operative Time; D010180:Pancreatectomy / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013156:Splenectomy / Q000379:methods* / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
keywords: Adenocarcinoma of pancreas; Distal pancreatectomy; Left pancreatectomy; RAMPS; Standardized tabular reporting