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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 3801-3811 |
| Number of pages | 11 |
| Journal | Cancer |
| Volume | 118 |
| Issue number | 15 |
| DOIs | |
| State | Published - Aug 1 2012 |
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Keywords
- pancreatic adenocarcinoma
- portal vein
- prognosis
- superior mesenteric vein
- survival
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation. / Wang, Jiansheng; Estrella, Jeannelyn S.; Peng, Lan; Rashid, Asif; Varadhachary, Gauri R.; Wang, Hua; Lee, Jeffrey E.; Pisters, Peter W T; Vauthey, Jean Nicolas; Katz, Matthew H.; Gomez, Henry F.; Evans, Douglas B.; Abbruzzese, James L.; Fleming, Jason B.; Wang, Huamin.
In: Cancer, Vol. 118, No. 15, 01.08.2012, p. 3801-3811.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation
AU - Wang, Jiansheng
AU - Estrella, Jeannelyn S.
AU - Peng, Lan
AU - Rashid, Asif
AU - Varadhachary, Gauri R.
AU - Wang, Hua
AU - Lee, Jeffrey E.
AU - Pisters, Peter W T
AU - Vauthey, Jean Nicolas
AU - Katz, Matthew H.
AU - Gomez, Henry F.
AU - Evans, Douglas B.
AU - Abbruzzese, James L.
AU - Fleming, Jason B.
AU - Wang, Huamin
PY - 2012/8/1
Y1 - 2012/8/1
N2 - 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.
AB - 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.
KW - pancreatic adenocarcinoma
KW - portal vein
KW - prognosis
KW - superior mesenteric vein
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=84864144630&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864144630&partnerID=8YFLogxK
U2 - 10.1002/cncr.26717
DO - 10.1002/cncr.26717
M3 - Article
C2 - 22180096
AN - SCOPUS:84864144630
VL - 118
SP - 3801
EP - 3811
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 15
ER -