Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein
Objective:. We hypothesized that preoperatively planned portal vein resection (PVR), which prevents from approaching tumors, improves survival in patients with resectable pancreatic head cancer adjacent to the portal vein (PhC-PV). Summary:. The decision to perform PVR is difficult in patients with...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2021-06-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000064 |
| _version_ | 1797732815642558464 |
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| author | Muga Terasawa, MD Yoshihiro Mise, , MD, PhD Ryuji Yoshioka, MD, PhD Atsushi Oba, MD, PhD Yoshihiro Ono, MD, PhD Yosuke Inoue, MD, PhD Hiroshi Imamura, MD, PhD Ito Hiromichi, MD, FACS Yu Takahashi, MD, PhD Seiji Kawasaki, MD, PhD Akio Saiura, MD, PhD |
| author_facet | Muga Terasawa, MD Yoshihiro Mise, , MD, PhD Ryuji Yoshioka, MD, PhD Atsushi Oba, MD, PhD Yoshihiro Ono, MD, PhD Yosuke Inoue, MD, PhD Hiroshi Imamura, MD, PhD Ito Hiromichi, MD, FACS Yu Takahashi, MD, PhD Seiji Kawasaki, MD, PhD Akio Saiura, MD, PhD |
| author_sort | Muga Terasawa, MD |
| collection | DOAJ |
| description | Objective:. We hypothesized that preoperatively planned portal vein resection (PVR), which prevents from approaching tumors, improves survival in patients with resectable pancreatic head cancer adjacent to the portal vein (PhC-PV).
Summary:. The decision to perform PVR is difficult in patients with resectable PhC-PV.
Methods:. This is a retrospective, bi-institutional study of patients undergoing pancreatoduodenectomy (PD) for resectable PhC-PV from 2009 to 2018. We compared clinical data of patients who underwent PD with preoperatively planned PVR (planned PVR group) and those who underwent conventional PD (cPD) in which decision to perform PVR was made intraoperatively (cPD group).
Results:. Among the study population of 176 patients, 53 patients (30.1%) underwent PD with planned PVR. The remaining 123 patients (69.9%) underwent cPD. Tumor characteristics were similar between the 2 groups. Operation time and major complication rates did not differ between the 2 groups. The local recurrence rate of patients in the planned PVR group (28.3%) was lower than that of the cPD group (44.7%; P = 0.041). Median overall survival (OS) was longer in the planned PVR group than in the cPD group (32 vs 27 months; P = 0.011). Multivariate analysis revealed that having undergone planned PVR was an independent factor for favorable OS (hazard ratio = 1.65; 95% confidence interval = 1.08–2.61; P = 0.021).
Conclusions:. The preoperative decision to perform PVR improves survival by enhancing local control of resectable PhC-PV. |
| first_indexed | 2024-03-12T12:19:59Z |
| format | Article |
| id | doaj.art-c1c5ca2eeef947af88e9a3177a334c9e |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-12T12:19:59Z |
| publishDate | 2021-06-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-c1c5ca2eeef947af88e9a3177a334c9e2023-08-30T06:08:35ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932021-06-0122e06410.1097/AS9.0000000000000064202106000-00014Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal VeinMuga Terasawa, MD0Yoshihiro Mise, , MD, PhD1Ryuji Yoshioka, MD, PhD2Atsushi Oba, MD, PhD3Yoshihiro Ono, MD, PhD4Yosuke Inoue, MD, PhD5Hiroshi Imamura, MD, PhD6Ito Hiromichi, MD, FACS7Yu Takahashi, MD, PhD8Seiji Kawasaki, MD, PhD9Akio Saiura, MD, PhD10From the * Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, JapanFrom the * Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, JapanFrom the * Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan† Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan† Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan† Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanFrom the * Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan† Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan† Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan‡ Department of Surgery, Mitsui Memorial Hospital, Tokyo, Japan.From the * Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, JapanObjective:. We hypothesized that preoperatively planned portal vein resection (PVR), which prevents from approaching tumors, improves survival in patients with resectable pancreatic head cancer adjacent to the portal vein (PhC-PV). Summary:. The decision to perform PVR is difficult in patients with resectable PhC-PV. Methods:. This is a retrospective, bi-institutional study of patients undergoing pancreatoduodenectomy (PD) for resectable PhC-PV from 2009 to 2018. We compared clinical data of patients who underwent PD with preoperatively planned PVR (planned PVR group) and those who underwent conventional PD (cPD) in which decision to perform PVR was made intraoperatively (cPD group). Results:. Among the study population of 176 patients, 53 patients (30.1%) underwent PD with planned PVR. The remaining 123 patients (69.9%) underwent cPD. Tumor characteristics were similar between the 2 groups. Operation time and major complication rates did not differ between the 2 groups. The local recurrence rate of patients in the planned PVR group (28.3%) was lower than that of the cPD group (44.7%; P = 0.041). Median overall survival (OS) was longer in the planned PVR group than in the cPD group (32 vs 27 months; P = 0.011). Multivariate analysis revealed that having undergone planned PVR was an independent factor for favorable OS (hazard ratio = 1.65; 95% confidence interval = 1.08–2.61; P = 0.021). Conclusions:. The preoperative decision to perform PVR improves survival by enhancing local control of resectable PhC-PV.http://journals.lww.com/10.1097/AS9.0000000000000064 |
| spellingShingle | Muga Terasawa, MD Yoshihiro Mise, , MD, PhD Ryuji Yoshioka, MD, PhD Atsushi Oba, MD, PhD Yoshihiro Ono, MD, PhD Yosuke Inoue, MD, PhD Hiroshi Imamura, MD, PhD Ito Hiromichi, MD, FACS Yu Takahashi, MD, PhD Seiji Kawasaki, MD, PhD Akio Saiura, MD, PhD Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein Annals of Surgery Open |
| title | Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein |
| title_full | Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein |
| title_fullStr | Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein |
| title_full_unstemmed | Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein |
| title_short | Preoperative Decision to Perform Portal Vein Resection Improves Survival in Patients With Resectable Pancreatic Head Cancer Adjacent to Portal Vein |
| title_sort | preoperative decision to perform portal vein resection improves survival in patients with resectable pancreatic head cancer adjacent to portal vein |
| url | http://journals.lww.com/10.1097/AS9.0000000000000064 |
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