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Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation.

Publication ,  Journal Article
Wang, J; Estrella, JS; Peng, L; Rashid, A; Varadhachary, GR; Wang, H; Lee, JE; Pisters, PWT; Vauthey, J-N; Katz, MH; Gomez, HF; Evans, DB ...
Published in: Cancer
August 1, 2012

BACKGROUND: Studies have shown that superior mesenteric vein (SMV)/portal vein (PV) resection with pancreaticoduodenectomy (PD) is safe and feasible for patient with pancreatic adenocarcinoma (PAC). However, the prognostic significance of tumor involvement of the resected vein in patients who received neoadjuvant therapy is unclear. METHODS: The authors evaluated 225 consecutive patients with stage II PAC who received neoadjuvant therapy and PD with or without SMV/PV resection. The resected SMV/PV was entirely submitted for histologic assessment and reviewed in all cases. Tumor involvement of the SMV/PV was correlated with clinicopathologic features and survival. RESULTS: Among the 225 patients, SMV/PV resection was performed in 85 patients. Histologic tumor involvement of the resected SMV/PV was identified in 57 patients. Histologic tumor involvement of the SMV/PV was associated with larger tumor size, higher rates of positive margin, and local/distant recurrence. By multivariate analysis, tumor involvement of the SMV/PV was an independent predictor of both disease-free survival (DFS) and overall survival (OS). However, addition of venous resection to PD itself had no impact on either DFS or OS compared with those with PD alone. CONCLUSIONS: Histologic tumor involvement of the SMV/PV is an independent predictor of both DFS and OS in patients with stage II PAC treated with neoadjuvant therapy and PD. Complete histologic evaluation of the resected SMV/PV is important for the prognosis in patients with PAC who received neoadjuvant therapy and PD.

Duke Scholars

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

August 1, 2012

Volume

118

Issue

15

Start / End Page

3801 / 3811

Location

United States

Related Subject Headings

  • Survival Analysis
  • Prognosis
  • Portal Vein
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Neoadjuvant Therapy
  • Middle Aged
  • Mesenteric Artery, Superior
  • Male
 

Citation

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ICMJE
MLA
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Wang, J., Estrella, J. S., Peng, L., Rashid, A., Varadhachary, G. R., Wang, H., … Fleming, J. B. (2012). Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation. Cancer, 118(15), 3801–3811. https://doi.org/10.1002/cncr.26717
Wang, Jiansheng, Jeannelyn S. Estrella, Lan Peng, Asif Rashid, Gauri R. Varadhachary, Hua Wang, Jeffrey E. Lee, et al. “Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation.Cancer 118, no. 15 (August 1, 2012): 3801–11. https://doi.org/10.1002/cncr.26717.
Wang J, Estrella JS, Peng L, Rashid A, Varadhachary GR, Wang H, Lee JE, Pisters PWT, Vauthey J-N, Katz MH, Gomez HF, Evans DB, Abbruzzese JL, Fleming JB. Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation. Cancer. 2012 Aug 1;118(15):3801–3811.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

August 1, 2012

Volume

118

Issue

15

Start / End Page

3801 / 3811

Location

United States

Related Subject Headings

  • Survival Analysis
  • Prognosis
  • Portal Vein
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Neoadjuvant Therapy
  • Middle Aged
  • Mesenteric Artery, Superior
  • Male