BACKGROUND: Studies have shown that superior mesenteric vein (SMV)/portal vein (PV) resection with pancreaticoduodenectomy (PD) is safe and feasible for patient with pancreatic adenocarcinoma (PAC). However, the prognostic significance of tumor involvement of the resected vein in patients who received neoadjuvant therapy is unclear. METHODS: The authors evaluated 225 consecutive patients with stage II PAC who received neoadjuvant therapy and PD with or without SMV/PV resection. The resected SMV/PV was entirely submitted for histologic assessment and reviewed in all cases. Tumor involvement of the SMV/PV was correlated with clinicopathologic features and survival. RESULTS: Among the 225 patients, SMV/PV resection was performed in 85 patients. Histologic tumor involvement of the resected SMV/PV was identified in 57 patients. Histologic tumor involvement of the SMV/PV was associated with larger tumor size, higher rates of positive margin, and local/distant recurrence. By multivariate analysis, tumor involvement of the SMV/PV was an independent predictor of both disease-free survival (DFS) and overall survival (OS). However, addition of venous resection to PD itself had no impact on either DFS or OS compared with those with PD alone. CONCLUSIONS: Histologic tumor involvement of the SMV/PV is an independent predictor of both DFS and OS in patients with stage II PAC treated with neoadjuvant therapy and PD. Complete histologic evaluation of the resected SMV/PV is important for the prognosis in patients with PAC who received neoadjuvant therapy and PD.
BACKGROUND: Studies have shown that superior mesenteric vein (SMV)/portal vein (PV) resection with pancreaticoduodenectomy (PD) is safe and feasible for patient with pancreatic adenocarcinoma (PAC). However, the prognostic significance of tumor involvement of the resected vein in patients who received neoadjuvant therapy is unclear. METHODS: The authors evaluated 225 consecutive patients with stage II PAC who received neoadjuvant therapy and PD with or without SMV/PV resection. The resected SMV/PV was entirely submitted for histologic assessment and reviewed in all cases. Tumor involvement of the SMV/PV was correlated with clinicopathologic features and survival. RESULTS: Among the 225 patients, SMV/PV resection was performed in 85 patients. Histologic tumor involvement of the resected SMV/PV was identified in 57 patients. Histologic tumor involvement of the SMV/PV was associated with larger tumor size, higher rates of positive margin, and local/distant recurrence. By multivariate analysis, tumor involvement of the SMV/PV was an independent predictor of both disease-free survival (DFS) and overall survival (OS). However, addition of venous resection to PD itself had no impact on either DFS or OS compared with those with PD alone. CONCLUSIONS: Histologic tumor involvement of the SMV/PV is an independent predictor of both DFS and OS in patients with stage II PAC treated with neoadjuvant therapy and PD. Complete histologic evaluation of the resected SMV/PV is important for the prognosis in patients with PAC who received neoadjuvant therapy and PD.
Authors: J H Allema; M E Reinders; T M van Gulik; D J van Leeuwen; L T de Wit; P C Verbeek; D J Gouma Journal: Br J Surg Date: 1994-11 Impact factor: 6.939
Authors: C Shibata; M Kobari; T Tsuchiya; K Arai; R Anzai; M Takahashi; M Uzuki; T Sawai; T Yamazaki Journal: World J Surg Date: 2001-08 Impact factor: 3.352
Authors: Ronnie T Poon; Sheung Tat Fan; Chung Mau Lo; Chi Leung Liu; Chi Ming Lam; Wai Key Yuen; Chun Yeung; John Wong Journal: World J Surg Date: 2004-06 Impact factor: 3.352
Authors: Mark Hartel; Marco Niedergethmann; Michael Farag-Soliman; Jörg W Sturm; Axel Richter; Michael Trede; Stefan Post Journal: Eur J Surg Date: 2002
Authors: Thomas J Howard; Nicholas Villanustre; Seth A Moore; John DeWitt; Julia LeBlanc; Dean Maglinte; Lee McHenry Journal: J Gastrointest Surg Date: 2003-12 Impact factor: 3.267
Authors: Jae P Jung; Mazen S Zenati; Ahmad Hamad; Melissa E Hogg; Richard L Simmons; Amer H Zureikat; Herbert J Zeh; Brian A Boone Journal: HPB (Oxford) Date: 2018-11-28 Impact factor: 3.647
Authors: Laura Prakash; Priya Bhosale; Jordan Cloyd; Michael Kim; Nathan Parker; James Yao; Arvind Dasari; Daniel Halperin; Thomas Aloia; Jeffrey E Lee; Jean Nicolas Vauthey; Jason B Fleming; Matthew H G Katz Journal: J Gastrointest Surg Date: 2016-09-15 Impact factor: 3.452
Authors: Hop S Tran Cao; Alpana Balachandran; Huamin Wang; Graciela M Nogueras-González; Christina E Bailey; Jeffrey E Lee; Peter W T Pisters; Douglas B Evans; Gauri Varadhachary; Christopher H Crane; Thomas A Aloia; Jean-Nicolas Vauthey; Jason B Fleming; Matthew H G Katz Journal: J Gastrointest Surg Date: 2013-10-16 Impact factor: 3.452
Authors: Deyali Chatterjee; Matthew H Katz; Asif Rashid; Jeannelyn S Estrella; Hua Wang; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Peter W Pisters; James L Abbruzzese; Jason B Fleming; Huamin Wang Journal: Histopathology Date: 2013-09-20 Impact factor: 5.087
Authors: Laurice K Fischer; Matthew H Katz; Sun M Lee; Li Liu; Hua Wang; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Anirban Maitra; Christina L Roland; Jason B Fleming; Jeannelyn Estrella; Asif Rashid; Huamin Wang Journal: Histopathology Date: 2015-06-19 Impact factor: 5.087
Authors: Kaitlyn J Kelly; Emily Winslow; David Kooby; Neha L Lad; Alexander A Parikh; Charles R Scoggins; Syed Ahmad; Robert C Martin; Shishir K Maithel; H J Kim; Nipun B Merchant; Clifford S Cho; Sharon M Weber Journal: J Gastrointest Surg Date: 2013-04-26 Impact factor: 3.452
Authors: Reza Nejati; Jennifer B Goldstein; Daniel M Halperin; Hua Wang; Nazila Hejazi; Asif Rashid; Matthew H Katz; Jeffrey E Lee; Jason B Fleming; Jaime Rodriguez-Canales; Jorge Blando; Ignacio I Wistuba; Anirban Maitra; Robert A Wolff; Gauri R Varadhachary; Huamin Wang Journal: Pancreas Date: 2017-10 Impact factor: 3.327
Authors: Olga Kantor; Mark S Talamonti; Susan J Stocker; Chi-Hsiung Wang; David J Winchester; David J Bentrem; Richard A Prinz; Marshall S Baker Journal: J Gastrointest Surg Date: 2016-02 Impact factor: 3.452