Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation

Jiansheng Wang, Jeannelyn S. Estrella, Lan Peng, Asif Rashid, Gauri R. Varadhachary, Hua Wang, Jeffrey E. Lee, Peter W T Pisters, Jean Nicolas Vauthey, Matthew H. Katz, Henry F. Gomez, Douglas B. Evans, James L. Abbruzzese, Jason B. Fleming, Huamin Wang

Research output: Contribution to journalArticle

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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 languageEnglish (US)
Pages (from-to)3801-3811
Number of pages11
JournalCancer
Volume118
Issue number15
DOIs
StatePublished - Aug 1 2012

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Mesenteric Veins
Portal Vein
Adenocarcinoma
Pancreaticoduodenectomy
Neoadjuvant Therapy
Neoplasms
Disease-Free Survival
Survival
Veins
Multivariate Analysis
Recurrence

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 journalArticle

Wang, J, Estrella, JS, Peng, L, Rashid, A, Varadhachary, GR, Wang, H, Lee, JE, Pisters, PWT, Vauthey, JN, Katz, MH, Gomez, HF, Evans, DB, Abbruzzese, JL, Fleming, JB & Wang, H 2012, 'Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation', Cancer, vol. 118, no. 15, pp. 3801-3811. https://doi.org/10.1002/cncr.26717
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. / Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation. In: Cancer. 2012 ; Vol. 118, No. 15. pp. 3801-3811.
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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.",
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author = "Jiansheng Wang and Estrella, {Jeannelyn S.} and Lan Peng and Asif Rashid and Varadhachary, {Gauri R.} and Hua Wang and Lee, {Jeffrey E.} and Pisters, {Peter W T} and Vauthey, {Jean Nicolas} and Katz, {Matthew H.} and Gomez, {Henry F.} and Evans, {Douglas B.} and Abbruzzese, {James L.} and Fleming, {Jason B.} and Huamin Wang",
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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

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U2 - 10.1002/cncr.26717

DO - 10.1002/cncr.26717

M3 - Article

C2 - 22180096

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VL - 118

SP - 3801

EP - 3811

JO - Cancer

JF - Cancer

SN - 0008-543X

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