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Mesenteric-Portal Vein Resection during Pancreatectomy for Pancreatic Cancer.

Beltrame V, Gruppo M, Pedrazzoli S, Merigliano S, Pastorelli D, Sperti C - Gastroenterol Res Pract (2015)

Bottom Line: Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR-: 30% and 4.0%, resp.).Mean and median survival time were 26 and 15 months, respectively, in VR- versus 20 and 14 months, respectively, in VR+ group (p = 0.52).Survival was worse for patients with histologically confirmed vascular infiltration.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, 35128 Padua, Italy.

ABSTRACT
The aim of the present study was to determine the outcome of patients undergoing pancreatic resection with (VR+) or without (VR-) mesenteric-portal vein resection for pancreatic carcinoma. Between January 1998 and December 2012, 241 patients with pancreatic cancer underwent pancreatic resection: in 64 patients, surgery included venous resection for macroscopic invasion of mesenteric-portal vein axis. Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR-: 30% and 4.0%, resp.). Radical resection was achieved in 55/64 (78%) in the VR+ group and in 126/177 (71%) in the VR- group. Vascular invasion was histologically proven in 44 (69%) of the VR+ group. Survival curves were not statistically different between the two groups. Mean and median survival time were 26 and 15 months, respectively, in VR- versus 20 and 14 months, respectively, in VR+ group (p = 0.52). In the VR+ group, only histologically proven vascular invasion significantly impacted survival (p = 0.02), while, in the VR- group, R0 resection (p = 0.001) and tumor's grading (p = 0.01) significantly influenced long-term survival. Vascular resection during pancreatectomy can be performed safely, with acceptable morbidity and mortality. Long-term survival was the same, with or without venous resection. Survival was worse for patients with histologically confirmed vascular infiltration.

No MeSH data available.


Related in: MedlinePlus

Overall survival in patients who underwent pancreatic resection with vascular resection and histological confirmation of vascular invasion.
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fig2: Overall survival in patients who underwent pancreatic resection with vascular resection and histological confirmation of vascular invasion.

Mentions: Mean and median overall survival time were 24 and 15 months, respectively. Mean survival time was 26 months for patients without vascular resection versus 20 months for VR+ group, while median survival time was 15 and 14 months, respectively (p = 0.31) (Table 3). Mean and median survival time for VR+ group without or with histological confirmation of venous involvement were 26 and 22 months versus 17 and 12 months, respectively (p = 0.02). Median survival in R0 patients was 17 months versus 10 months in R1 group. Overall survival was 42% at 1 yr, 10% at 2 yrs, and 2% at 3, 4, and 5 yrs (Figure 1). In patients without evidence of vascular invasion, overall survival was 69% at 1 yr, 31% at 2 yrs, 6% at 3 yrs, and 6% at 5 yrs versus 30% at 1 yr and 0% at 2 yrs in subjects with confirmed vascular infiltration (Figure 2). There was a trend of worse prognosis for patients with deeper portal vein invasion without statistical significance (p = 0.08).


Mesenteric-Portal Vein Resection during Pancreatectomy for Pancreatic Cancer.

Beltrame V, Gruppo M, Pedrazzoli S, Merigliano S, Pastorelli D, Sperti C - Gastroenterol Res Pract (2015)

Overall survival in patients who underwent pancreatic resection with vascular resection and histological confirmation of vascular invasion.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644545&req=5

fig2: Overall survival in patients who underwent pancreatic resection with vascular resection and histological confirmation of vascular invasion.
Mentions: Mean and median overall survival time were 24 and 15 months, respectively. Mean survival time was 26 months for patients without vascular resection versus 20 months for VR+ group, while median survival time was 15 and 14 months, respectively (p = 0.31) (Table 3). Mean and median survival time for VR+ group without or with histological confirmation of venous involvement were 26 and 22 months versus 17 and 12 months, respectively (p = 0.02). Median survival in R0 patients was 17 months versus 10 months in R1 group. Overall survival was 42% at 1 yr, 10% at 2 yrs, and 2% at 3, 4, and 5 yrs (Figure 1). In patients without evidence of vascular invasion, overall survival was 69% at 1 yr, 31% at 2 yrs, 6% at 3 yrs, and 6% at 5 yrs versus 30% at 1 yr and 0% at 2 yrs in subjects with confirmed vascular infiltration (Figure 2). There was a trend of worse prognosis for patients with deeper portal vein invasion without statistical significance (p = 0.08).

Bottom Line: Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR-: 30% and 4.0%, resp.).Mean and median survival time were 26 and 15 months, respectively, in VR- versus 20 and 14 months, respectively, in VR+ group (p = 0.52).Survival was worse for patients with histologically confirmed vascular infiltration.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, 35128 Padua, Italy.

ABSTRACT
The aim of the present study was to determine the outcome of patients undergoing pancreatic resection with (VR+) or without (VR-) mesenteric-portal vein resection for pancreatic carcinoma. Between January 1998 and December 2012, 241 patients with pancreatic cancer underwent pancreatic resection: in 64 patients, surgery included venous resection for macroscopic invasion of mesenteric-portal vein axis. Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR-: 30% and 4.0%, resp.). Radical resection was achieved in 55/64 (78%) in the VR+ group and in 126/177 (71%) in the VR- group. Vascular invasion was histologically proven in 44 (69%) of the VR+ group. Survival curves were not statistically different between the two groups. Mean and median survival time were 26 and 15 months, respectively, in VR- versus 20 and 14 months, respectively, in VR+ group (p = 0.52). In the VR+ group, only histologically proven vascular invasion significantly impacted survival (p = 0.02), while, in the VR- group, R0 resection (p = 0.001) and tumor's grading (p = 0.01) significantly influenced long-term survival. Vascular resection during pancreatectomy can be performed safely, with acceptable morbidity and mortality. Long-term survival was the same, with or without venous resection. Survival was worse for patients with histologically confirmed vascular infiltration.

No MeSH data available.


Related in: MedlinePlus