BACKGROUND AND OBJECTIVES: Arterial resection (AR) has traditionally been considered as a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma. The objective was to evaluate if pancreatic resection with AR was worthwhile. METHODS: Between January 1990 and December 2008 the records of 26 consecutive patients who underwent a curative-intent pancreatic resection for adenocarcinoma of the pancreas with AR (AR+ group) were matched 1:1 to those of the whole series of pancreatic resection performed in our institution. The final study population (n = 52) included two groups of patients: the study group AR+ = 26 and the control group AR- = 26. RESULTS: The 1- and 3-year survival rates were similar in the two groups (65.9% and 22.1%, median 17 months for the group AR + , versus 50.0% and 17.6%, median 12 months, for the group AR-; P = 0.581). The multivariate analysis showed that: arterial wall invasion at the site of AR, the total number of resected lymph nodes of ≤15, and perineural invasion were independent prognostic factors for survival. CONCLUSION: Pancreatic resections with AR for adenocarcinoma allowed to obtain a 3-survival rate similar to that of a matched group of patients not requiring AR.
BACKGROUND AND OBJECTIVES: Arterial resection (AR) has traditionally been considered as a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma. The objective was to evaluate if pancreatic resection with AR was worthwhile. METHODS: Between January 1990 and December 2008 the records of 26 consecutive patients who underwent a curative-intent pancreatic resection for adenocarcinoma of the pancreas with AR (AR+ group) were matched 1:1 to those of the whole series of pancreatic resection performed in our institution. The final study population (n = 52) included two groups of patients: the study group AR+ = 26 and the control group AR- = 26. RESULTS: The 1- and 3-year survival rates were similar in the two groups (65.9% and 22.1%, median 17 months for the group AR + , versus 50.0% and 17.6%, median 12 months, for the group AR-; P = 0.581). The multivariate analysis showed that: arterial wall invasion at the site of AR, the total number of resected lymph nodes of ≤15, and perineural invasion were independent prognostic factors for survival. CONCLUSION: Pancreatic resections with AR for adenocarcinoma allowed to obtain a 3-survival rate similar to that of a matched group of patients not requiring AR.
Authors: Marc W Fromer; Jenci Hawthorne; Prejesh Philips; Michael E Egger; Charles R Scoggins; Kelly M McMasters; Robert C G Martin Journal: Ann Surg Oncol Date: 2021-06-04 Impact factor: 5.344