Faculty Collaboration Database

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 Aug 01;118(15):3801-11

Date

12/20/2011

Pubmed ID

22180096

Pubmed Central ID

PMC3310937

DOI

10.1002/cncr.26717

Scopus ID

2-s2.0-84864144630 (requires institutional sign-in at Scopus site)   58 Citations

Abstract

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.

Author List

Wang J, Estrella JS, Peng L, Rashid A, Varadhachary GR, Wang H, Lee JE, Pisters PW, Vauthey JN, Katz MH, Gomez HF, Evans DB, Abbruzzese JL, Fleming JB, Wang H

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Disease-Free Survival
Female
Humans
Male
Mesenteric Artery, Superior
Middle Aged
Neoadjuvant Therapy
Neoplasm Invasiveness
Pancreatic Neoplasms
Portal Vein
Prognosis
Survival Analysis