TY - JOUR
T1 - Splenic-vasculature involvement is associated with poor prognosis in resected distal pancreatic cancer
AU - Yin, Feng
AU - Saad, Mohammed
AU - Lin, Jingmei
AU - Jackson, Christopher R.
AU - Ren, Bing
AU - Lawson, Cynthia
AU - Karamchandani, Dipti M.
AU - Bernabeu, Belen Quereda
AU - Jiang, Wei
AU - Dhir, Teena
AU - Zheng, Richard
AU - Schultz, Christopher W.
AU - Zhang, Dongwei
AU - Thomas, Courtney L.
AU - Zhang, Xuchen
AU - Lai, Jinping
AU - Schild, Michael
AU - Zhang, Xuefeng
AU - Xie, Hao
AU - Liu, Xiuli
N1 - Publisher Copyright:
© 2020 The Author(s) 2020.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: Distal pancreatic carcinoma is one of the most lethal cancers largely due to its high incidence of distant metastasis. This study aims to assess the prognostic value of splenic-vasculature involvement in resected distal pancreatic carcinoma. Methods: In this retrospective study, we collected the clinicopathologic information of 454 patients with pancreatic cancer and performed univariate and multivariate analyses to identify factors associated with progression-free survival (PFS) and overall survival (OS), with an emphasis on the prognostic value of splenic-artery and -vein involvement. Results: Univariate analysis revealed that larger tumor size, non-intraductal papillary mucinous neoplasm (non-IPMN)-associated adenocarcinoma, poor differentiation, stage pT3, nodal metastasis, lymphovascular invasion, perineural invasion, and pathologic and radiographic evidence of splenic-vein invasion were significantly associated with shorter PFS and OS (all P < 0.05). Multivariate analysis confirmed non-IPMN-associated adenocarcinoma, stage pT3, stage pN1-2, and post-operative adjuvant chemotherapy as independent risk factors for both PFS and OS, and larger tumor size and radiographic evidence of splenic-artery invasion as predictors of PFS only. Conclusion: Guidelines should be developed for a uniform approach with regard to the examination and reporting of the status of the splenic vasculature when dealing with distal-pancreatic-cancer specimens.
AB - Background: Distal pancreatic carcinoma is one of the most lethal cancers largely due to its high incidence of distant metastasis. This study aims to assess the prognostic value of splenic-vasculature involvement in resected distal pancreatic carcinoma. Methods: In this retrospective study, we collected the clinicopathologic information of 454 patients with pancreatic cancer and performed univariate and multivariate analyses to identify factors associated with progression-free survival (PFS) and overall survival (OS), with an emphasis on the prognostic value of splenic-artery and -vein involvement. Results: Univariate analysis revealed that larger tumor size, non-intraductal papillary mucinous neoplasm (non-IPMN)-associated adenocarcinoma, poor differentiation, stage pT3, nodal metastasis, lymphovascular invasion, perineural invasion, and pathologic and radiographic evidence of splenic-vein invasion were significantly associated with shorter PFS and OS (all P < 0.05). Multivariate analysis confirmed non-IPMN-associated adenocarcinoma, stage pT3, stage pN1-2, and post-operative adjuvant chemotherapy as independent risk factors for both PFS and OS, and larger tumor size and radiographic evidence of splenic-artery invasion as predictors of PFS only. Conclusion: Guidelines should be developed for a uniform approach with regard to the examination and reporting of the status of the splenic vasculature when dealing with distal-pancreatic-cancer specimens.
KW - intraductal papillary mucinous neoplasm
KW - pancreatic cancer
KW - prognosis
KW - splenic artery
KW - splenic vein
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U2 - 10.1093/gastro/goaa084
DO - 10.1093/gastro/goaa084
M3 - Article
C2 - 34026221
AN - SCOPUS:85107422009
SN - 2052-0034
VL - 9
SP - 139
EP - 145
JO - Gastroenterology Report
JF - Gastroenterology Report
IS - 2
ER -