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- Title
Long-term outcome of portomesenteric vein invasion and prognostic factors in pancreas head adenocarcinoma.
- Authors
Jeong, Jaehong; Choi, Dong W.; Choi, Seong H.; Heo, Jin S.; Jang, Kee‐Taek
- 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.
- Subjects
PANCREATIC cancer; CANCER patients; PANCREATIC cancer treatment; ADENOCARCINOMA; CANCER treatment; HEALTH outcome assessment; PORTAL vein diseases; PANCREATICODUODENECTOMY
- Publication
ANZ Journal of Surgery, 2015, Vol 85, Issue 4, p264
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/ans.12502