Prognostic impact of simultaneous venous resections during surgery for resectable pancreatic cancer
| Autor: | Stefan Löb, Anna Döring, Johan Friso Lock, Christoph-Thomas Germer, Armin Wiegering, Julia Schützler, Friedrich Anger, Volker Kunzmann, Nicolas Schlegel, Ingo Klein |
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| Rok vydání: | 2020 |
| Předmět: |
Resectable Pancreatic Cancer
medicine.medical_specialty Adjuvant chemotherapy medicine.medical_treatment Disease free Subgroup analysis Adenocarcinoma 030230 surgery 03 medical and health sciences Mesenteric Veins 0302 clinical medicine medicine Humans Risk factor Vein Retrospective Studies Hepatology business.industry Gastroenterology Prognosis medicine.disease Pancreaticoduodenectomy Surgery Pancreatic Neoplasms medicine.anatomical_structure 030220 oncology & carcinogenesis business |
| Zdroj: | HPB. 22:1384-1393 |
| ISSN: | 1365-182X |
| Popis: | Background The aim of this study was to evaluate the prognostic impact of simultaneous venous resection during pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PDAC) that was preoperatively staged resectable according to NCCN guidelines. Methods A retrospective analysis of 153 patients who underwent PD for PDAC was performed. Patients were divided into standard PD and PD with simultaneous vein resection (PDVR). Groups were compared to each other in terms of postoperative morbidity and mortality, disease free (DFS) and overall survival (OS). Results 114 patients received PD while 39 patients received PDVR. No differences in terms of postoperative morbidity and mortality between both groups were detected. Patients in the VR group presented with a significantly shorter OS in the median (13 vs. 21 months, P = 0.011). In subgroup analysis, resection status did not influence OS in the PDVR group (R0 13 vs. R1 12 months, P = 0.471) but in the PD group (R0 23 vs. R1 14 months, P = 0.043). PDVR was a risk factor of OS in univariate but not multivariable analysis. Conclusion PDVR for PDAC preoperatively staged resectable resulted in significantly shorter OS regardless of resection status. Patients who require PDVR should be considered for adjuvant chemotherapy in addition to other oncological indications. |
| Databáze: | OpenAIRE |
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