Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience

BMC Surg. 2015 Aug 22:15:100. doi: 10.1186/s12893-015-0086-1.

Abstract

Background: 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.

Methods: 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).

Results: 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).

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Aged
  • Female
  • Humans
  • Male
  • Mesenteric Veins / pathology
  • Mesenteric Veins / surgery
  • Neoplasm Invasiveness
  • Pancreatectomy
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy
  • Portal Vein / pathology
  • Portal Vein / surgery
  • Retrospective Studies
  • Treatment Outcome