Introduction : Radical antegrade modular pancreatosplenectomy (RAMPS) has been reported to achieve better negative margin and to retrieve more lymph node compared with conventional distal pancreatectomy. Until now, many studies were historical control and the results remain controversial. In this study we evaluated surgical outcomes and long-term prognosis of RAMPS compared with conventional resection through multicenter in recent period.

Methods : A total 106 patients who underwent curative resection for left side Pancreatic cancer in two hospitals (Gangnam Severance Hospital, St Mary’s hospital) from 2012 to 2017 were reviewed. Overall survival and recurrence-free survival rates were compared using Kaplan–Meier estimates.

Results : Before propensity scores matching, in RAMPS group had more advanced T and N stage and large tumor size than conventional group. And metastatic lymph node was more harvested in RAMPS group (p=0.02). After propensity scores matching based on T stage and N stage, 37 patients (RAMPS) and 37 patients( Conventional DP) were included in the analysis. There was no difference in disease free survival ( p = 0.463) and overall survival ( p = 0.383) between the two groups in Kaplan meier survival analysis. On multivariate analyses, completion of chemotherapy was identified as independent factors for disease-free survival(p <0.001) and overall survival(p<0.001).

Conclusions : The two procedures compared showed no difference in survival rates. In advanced tumors, RAMPS procedure may be one option for R0 resection. In all distal pancreatectomy cases for pancreatic cancer, it is not necessary to do so unconditionally. The role of postoperative chemotherapy in pancreatic cancer seems to be more important.