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Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma.
ANZ J Surg. 2015 Apr; 85(4):264-9.AJ

Abstract

BACKGROUND

The purpose of this study was to clarify the post-operative prognosis of pancreatic head cancer with pathologic portal vein (PV) or superior mesenteric vein (SMV) invasion.

METHODS

From May 1995 to December 2009, preoperative, intra-operative and post-operative data from 276 patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma were reviewed retrospectively. The long-term prognosis was compared between patients with a pathologic PV-SMV invasion and those without invasion.

RESULTS

Fourty-six patients (16.7%) underwent PV-SMV resection during pancreaticoduodenectomy. Pathologic PV-SMV invasion was observed in 30 (65.2%). Post-operative severe morbidity (grade 3 or 4) was similar for patients with and without PV-SMV resection (8.7% with versus 7.0% without P = 0.754). The mortality rate was 2.2% with PV-SMV resection and 0.9% without PV-SMV resection (P = 0.423). Survival of PV-SMV resection and no resection group had no significant difference (median survival, 16 versus 12 months; P = 0.086). No significant difference in overall survival was seen between patients with and without pathologic PV-SMV invasion (median survival, 13 versus 16 months; P = 0.663). Tumour differentiation, R status, tumour size and type of operation were revealed as independent prognostic factors.

CONCLUSIONS

34.8% of patients who underwent PV-SMV resection had no pathologic invasion. And PV-SMV resection did not increase the rate of severe complications and mortality. Furthermore, the prognosis for patients with pathologic PV-SMV invasion may be nearly the same as patients with no invasion. So, PV-SMV resection with reconstruction should be considered in pancreatic head cancer patients with suspected PV-SMV invasion.

Authors+Show Affiliations

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

24641800

Citation

Jeong, Jaehong, et al. "Long-term Outcome of Portomesenteric Vein Invasion and Prognostic Factors in Pancreas Head Adenocarcinoma." ANZ Journal of Surgery, vol. 85, no. 4, 2015, pp. 264-9.
Jeong J, Choi DW, Choi SH, et al. Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma. ANZ J Surg. 2015;85(4):264-9.
Jeong, J., Choi, D. W., Choi, S. H., Heo, J. S., & Jang, K. T. (2015). Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma. ANZ Journal of Surgery, 85(4), 264-9. https://doi.org/10.1111/ans.12502
Jeong J, et al. Long-term Outcome of Portomesenteric Vein Invasion and Prognostic Factors in Pancreas Head Adenocarcinoma. ANZ J Surg. 2015;85(4):264-9. PubMed PMID: 24641800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma. AU - Jeong,Jaehong, AU - Choi,Dong W, AU - Choi,Seong H, AU - Heo,Jin S, AU - Jang,Kee-Taek, Y1 - 2014/02/12/ PY - 2013/11/24/accepted PY - 2014/3/20/entrez PY - 2014/3/20/pubmed PY - 2015/12/23/medline KW - adenocarcinoma KW - pancreas KW - portal vein KW - prognosis KW - survival SP - 264 EP - 9 JF - ANZ journal of surgery JO - ANZ J Surg VL - 85 IS - 4 N2 - BACKGROUND: The purpose of this study was to clarify the post-operative prognosis of pancreatic head cancer with pathologic portal vein (PV) or superior mesenteric vein (SMV) invasion. METHODS: From May 1995 to December 2009, preoperative, intra-operative and post-operative data from 276 patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma were reviewed retrospectively. The long-term prognosis was compared between patients with a pathologic PV-SMV invasion and those without invasion. RESULTS: Fourty-six patients (16.7%) underwent PV-SMV resection during pancreaticoduodenectomy. Pathologic PV-SMV invasion was observed in 30 (65.2%). Post-operative severe morbidity (grade 3 or 4) was similar for patients with and without PV-SMV resection (8.7% with versus 7.0% without P = 0.754). The mortality rate was 2.2% with PV-SMV resection and 0.9% without PV-SMV resection (P = 0.423). Survival of PV-SMV resection and no resection group had no significant difference (median survival, 16 versus 12 months; P = 0.086). No significant difference in overall survival was seen between patients with and without pathologic PV-SMV invasion (median survival, 13 versus 16 months; P = 0.663). Tumour differentiation, R status, tumour size and type of operation were revealed as independent prognostic factors. CONCLUSIONS: 34.8% of patients who underwent PV-SMV resection had no pathologic invasion. And PV-SMV resection did not increase the rate of severe complications and mortality. Furthermore, the prognosis for patients with pathologic PV-SMV invasion may be nearly the same as patients with no invasion. So, PV-SMV resection with reconstruction should be considered in pancreatic head cancer patients with suspected PV-SMV invasion. SN - 1445-2197 UR - https://www.unboundmedicine.com/medline/citation/24641800/Long_term_outcome_of_portomesenteric_vein_invasion_and_prognostic_factors_in_pancreas_head_adenocarcinoma_ L2 - https://doi.org/10.1111/ans.12502 DB - PRIME DP - Unbound Medicine ER -