ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC
Pancreaticoduodenal resection (PDR) with vascular reconstruction is performed in approximately 20 % of pancreatic cancer patients. The superior mesenteric vein resection and reconstruction has become a standard routine surgery, whereas arterial resection during pancreatic surgery is still an issue o...
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| Format: | Article |
| Language: | Russian |
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Russian Academy of Sciences, Tomsk National Research Medical Center
2020-10-01
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| Series: | Сибирский онкологический журнал |
| Subjects: | |
| Online Access: | https://www.siboncoj.ru/jour/article/view/1582 |
| _version_ | 1826563669833547776 |
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| author | D. A. Сhichevatov V. V. Kalentev A. E. Glukhov |
| author_facet | D. A. Сhichevatov V. V. Kalentev A. E. Glukhov |
| author_sort | D. A. Сhichevatov |
| collection | DOAJ |
| description | Pancreaticoduodenal resection (PDR) with vascular reconstruction is performed in approximately 20 % of pancreatic cancer patients. The superior mesenteric vein resection and reconstruction has become a standard routine surgery, whereas arterial resection during pancreatic surgery is still an issue of controversial debate.The purpose of the study was to evaluate short-and long-term outcomes of PDR with reconstruction of various arteries.Material and Methods. Outcomes of 89 PDRs and pancreaticoduodenectomies performed in patients with stage II–IV periampullary carcinoma were assessed. The average age of the patients was 63.1 ± 8.2. There were 18 (20.2 %) PDRs with vascular reconstruction, of them 7 (7.8 %) were arterial resections.Results. In patients who underwent artery resection (n=7), complications were observed in 5 (71.4 %) cases. Out of 71 patients who underwent PDR without arterial and/or venous resection, 29 (40.8 %) had complications (p=0.229). The postoperative mortality rates were 1 (14.3 %) and 3 (4.2 %), respectively (p=0.319). The median disease-free survival was 5.0 months (95 % CI 2.4–7.6 months) in the arterial resection group and 12.3 months (95 % CI 9.2–15.4 months) in the standard surgery group (log-rank test, p=0,011). The median overall survival was 8.0 months (95 % CI 3.7–12.3 months) in the in the arterial resection group and 21.8 months (95 % CI 15.9–27.7 months) in the standard surgery group (log-rank test, p=0.011).Conclusion. The disease-free and overall survival rates were significantly worse in the arterial resection group than in the standard surgery group. This is most likely due to a small sample of patients. Further studies are needed to analyze the immediate and long-term treatment outcomes of PDR with arterial resection for pancreatic cancer. |
| first_indexed | 2024-04-10T01:52:02Z |
| format | Article |
| id | doaj.art-4960c7d919804a6eb5cbaa38b77792fa |
| institution | Directory Open Access Journal |
| issn | 1814-4861 2312-3168 |
| language | Russian |
| last_indexed | 2025-03-14T10:07:39Z |
| publishDate | 2020-10-01 |
| publisher | Russian Academy of Sciences, Tomsk National Research Medical Center |
| record_format | Article |
| series | Сибирский онкологический журнал |
| spelling | doaj.art-4960c7d919804a6eb5cbaa38b77792fa2025-03-02T11:16:13ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682020-10-01195828710.21294/1814-4861-2020-19-5-82-87791ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENCD. A. Сhichevatov0V. V. Kalentev1A. E. Glukhov2Penza Institute for Further Training of Physicians – branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRegional Oncology Health CenterPenza Institute for Further Training of Physicians – branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationPancreaticoduodenal resection (PDR) with vascular reconstruction is performed in approximately 20 % of pancreatic cancer patients. The superior mesenteric vein resection and reconstruction has become a standard routine surgery, whereas arterial resection during pancreatic surgery is still an issue of controversial debate.The purpose of the study was to evaluate short-and long-term outcomes of PDR with reconstruction of various arteries.Material and Methods. Outcomes of 89 PDRs and pancreaticoduodenectomies performed in patients with stage II–IV periampullary carcinoma were assessed. The average age of the patients was 63.1 ± 8.2. There were 18 (20.2 %) PDRs with vascular reconstruction, of them 7 (7.8 %) were arterial resections.Results. In patients who underwent artery resection (n=7), complications were observed in 5 (71.4 %) cases. Out of 71 patients who underwent PDR without arterial and/or venous resection, 29 (40.8 %) had complications (p=0.229). The postoperative mortality rates were 1 (14.3 %) and 3 (4.2 %), respectively (p=0.319). The median disease-free survival was 5.0 months (95 % CI 2.4–7.6 months) in the arterial resection group and 12.3 months (95 % CI 9.2–15.4 months) in the standard surgery group (log-rank test, p=0,011). The median overall survival was 8.0 months (95 % CI 3.7–12.3 months) in the in the arterial resection group and 21.8 months (95 % CI 15.9–27.7 months) in the standard surgery group (log-rank test, p=0.011).Conclusion. The disease-free and overall survival rates were significantly worse in the arterial resection group than in the standard surgery group. This is most likely due to a small sample of patients. Further studies are needed to analyze the immediate and long-term treatment outcomes of PDR with arterial resection for pancreatic cancer.https://www.siboncoj.ru/jour/article/view/1582pancreatic cancerpancreatectomypancreaticoduodenal resectionarterial resectionvascular reconstruction |
| spellingShingle | D. A. Сhichevatov V. V. Kalentev A. E. Glukhov ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC Сибирский онкологический журнал pancreatic cancer pancreatectomy pancreaticoduodenal resection arterial resection vascular reconstruction |
| title | ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC |
| title_full | ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC |
| title_fullStr | ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC |
| title_full_unstemmed | ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC |
| title_short | ARTERIAL RESECTION IN PANCREATIC CANCER SURGERY: A SINGLE-CENTER EXPERIENC |
| title_sort | arterial resection in pancreatic cancer surgery a single center experienc |
| topic | pancreatic cancer pancreatectomy pancreaticoduodenal resection arterial resection vascular reconstruction |
| url | https://www.siboncoj.ru/jour/article/view/1582 |
| work_keys_str_mv | AT dashichevatov arterialresectioninpancreaticcancersurgeryasinglecenterexperienc AT vvkalentev arterialresectioninpancreaticcancersurgeryasinglecenterexperienc AT aeglukhov arterialresectioninpancreaticcancersurgeryasinglecenterexperienc |