Helmut Friess and Jorg Kleeff contributed equally to this work.
All authors declare that there is no potential or actual conflict of interest.
CWM, ME, JK designed the study. CJ, SK, BB, RB, IE contributed to data acquisition. BK, RB, IE contributed to data analysis and interpretation. CWM, ME, JK drafted the manuscript. BK, CJ, SK, BB, RB, IE, HF revised the manuscript critically for important intellectual content. All authors approved the final version of the manuscript.
Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the portal/superior mesenteric vein (PV/SMV). Here, we analyzed this group of patients, with emphasis on short and long-term outcomes.
156 patients who underwent a resection for PDAC were included in the analysis and sub-stratified into a cohort of patients with PV/SMV resection (n = 54) versus those with standard surgeries (n = 102).
While venous resections could be performed safely, there was a trend towards shorter median survival in the PV/SMV resection group (22.7 vs. 15.8 months, p = 0.157). These tumors were significantly larger (3.5 vs 4.3 cm; p = 0.026) and margin-positivity was more frequent (30.4 % vs 44.4 %, p = 0.046).
Venous resection was associated with a higher rate of margin positivity and a trend towards shorter survival. However, compared to non-surgical treatment, resection offers the best chance for long term survival.
Wang J, Estrella JS, Peng L, Rashid A, Varadhachary GR, Wang H, et al. Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation. Cancer. 2012;118(15):3801–11. CrossRefPubMed
- Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience
Christoph W. Michalski
- BioMed Central
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