ReviewsPancreatoduodenectomy With Arterial Resection for Locally Advanced Pancreatic Cancer of the Head A Systematic ReviewHaines, Morgan B Med, MD*; Chua, Terence C. MBBS, BScMed(Hons), PhD, MRCS(Ed), FRACS†,‡; Jamieson, Nigel B. PhD§; Mittal, Anubhav PhD*; Gill, Anthony J. PhD∥,¶; Samra, Jaswinder S. DPhil (Oxon)*,#Author Information From the *Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales †Department of Surgery, QE II Jubilee Hospital, Brisbane ‡School of Medicine, Griffith University, Gold Coast, Queensland, Australia §School of Medicine, University of Glasgow, Glasgow, United Kingdom ∥Department of Anatomical Pathology, Royal North Shore Hospital ¶Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research #Faculty of Medical and Health Sciences, Macquarie University, Sydney, New South Wales, Australia. Received for publication September 19, 2019; accepted March 16, 2020. Address correspondence to: Terence Chua, MBBS, BScMed(Hons), PhD, MRCS(Ed), FRACS, Department of Surgery, QE II Jubilee Hospital, Troughton Rd & Kessels Rd, Coopers Plains, Brisbane QLD 4108, Australia (e-mail: firstname.lastname@example.org). The authors declare no conflict of interest. M.H., T.C.C., N.J.B., A.M., A.J.G., and J.S.S. did the conception and design. M.H. and T.C.C. did the data collection. M.H., T.C.C., and J.S.S. did the analysis of results. M.H., T.C.C., N.J.B., A.M., A.J.G., and J.S.S. did the drafting of manuscript. M.H., T.C.C., N.J.B., A.M., A.J.G., and J.S.S. did the final approval. Pancreas: May/June 2020 - Volume 49 - Issue 5 - p 621-628 doi: 10.1097/MPA.0000000000001551 Buy Metrics Abstract The development of increasingly effective chemotherapy regimens and increasing tumor necrosis is allowing radical pancreatectomy to be re-evaluated. This systematic review examines the outcome of patients with locally advanced cancer of the pancreatic head after pancreatectomy with arterial resection. Electronic searches were performed on PubMed and Medline databases between January 2000 and December 2018. The end points were to determine the safety and overall survival after arterial resection in pancreatectomy. Thirteen studies with 467 patients were included. Celiac, hepatic, mesenteric, and splenic arteries were resected across all studies. The median overall morbidity was 52% (range, 37%–100%) and with major complications occurring in a median of 25% (range, 12%–54%) of patients. The median 90-day mortality was 5% (range, 0%–17%). R0 was achieved in 66% (range, 43%–100%) and R1 in 31% (range, 0%–74%). The median survival was 17 (range, 7–29) months with a 1- and 3-year survival of 59% (range, 16%–92%) and 17% (range, 0%–13%), respectively. Pancreatectomy with arterial resection may be safely performed in high-volume centers with acceptable survival results in highly selected patients. Pooling of data through a multi-institutional registry will allow a more accurate assessment of the safety and efficacy of this treatment strategy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.