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Portomesenteric venous contact ≤180° and overall survival in resectable head and body pancreatic adenocarcinoma treated with upfront surgery
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0002-8601-0159
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.ORCID iD: 0000-0002-4877-5150
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2023 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 49, no 11, article id 107097Article in journal (Refereed) Published
Abstract [en]

Introduction: Upfront surgery is the standard of care for resectable pancreatic cancer, defined as the absence of or ≤180° tumour contact with the portal/superior mesenteric vein. We hypothesized that portomesenteric venous contact is prognostically unfavourable and aimed to assess whether it is associated with poorer outcomes compared with no venous contact in resectable head and body pancreatic cancer.

Methods: This single-centre retrospective study included patients undergoing upfront surgery for resectable head and body pancreatic cancer in 2010–2020 at Umeå University Hospital, Sweden. No venous contact was compared with portomesenteric venous contact of ≤180° based on preoperative imaging. Survival on an intention-to-treat basis was compared with Kaplan-Meier curves, a log-rank test and Cox proportional hazards models.

Results: The final study cohort included 39 patients with portomesenteric venous contact and 144 patients without venous contact. Patients with portomesenteric tumour contact had a median overall survival of 15.3 months compared to 23.0 months (log rank P = 0.059). Portomesenteric venous contact was an independent negative prognostic factor for survival in the multivariable Cox model (HR 1.68; 95% CI 1.11–2.55, P = 0.014) and was associated with higher rates of microscopically non-radical resections (R1) (50% vs 26.1%, P = 0.012) and pathological lymph node metastasis (76.7% vs 56.8%, P = 0.012). There was no difference in adjuvant chemotherapy receipt or postoperative complications between the groups.

Conclusions: Portomesenteric venous contact is associated with poorer overall survival and higher rates of R1 resections and lymph node metastasis in patients with resectable head and body pancreatic cancer treated with upfront surgery.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 49, no 11, article id 107097
Keywords [en]
Pancreatic adenocarcinoma
National Category
Surgery
Research subject
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-214812DOI: 10.1016/j.ejso.2023.107097PubMedID: 37804583Scopus ID: 2-s2.0-85173010733OAI: oai:DiVA.org:umu-214812DiVA, id: diva2:1801443
Funder
Umeå University, AMP 23-1127Region Västerbotten, RV-979958Swedish Society of Medicine, SLS-960379The Royal Swedish Academy of Sciences, LM2021-0010Region Västerbotten, RV-982574Region Västerbotten, RV--982481Bengt Ihres Foundation, SLS-960529Knut and Alice Wallenberg Foundation, RV-769711Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-02-01Bibliographically approved

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Molnár, AdrienneHalimi, AsifSvensson, JohanBayadsi, HaythamInnala, MarcusHemmingsson, OskarFranklin, Oskar

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Molnár, AdrienneHalimi, AsifSvensson, JohanBayadsi, HaythamInnala, MarcusHemmingsson, OskarFranklin, Oskar
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SurgeryStatisticsDepartment of Radiation SciencesWallenberg Centre for Molecular Medicine at Umeå University (WCMM)
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European Journal of Surgical Oncology
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