Artikel
What are Prognostic Factors after Portal Venous Resection for Pancreatic Ductual Adenocarcioma?
Suche in Medline nach
Autoren
Veröffentlicht: | 24. April 2015 |
---|
Gliederung
Text
Introduction: Portal venous resection (PVR) for pancreatic ductal adenocarcinoma (PDAC) is performed routinely in case of adhesion to the portal vein. Data on the oncologic impact of tumor characteristics on survival in this situation is limited. The aim was to identify prognostic factors after PVR for PDAC.
Material and methods: Retrospective analysis was performed on the basis of a prospectively maintained database and archived paraffin-embedded formalin fixed tissue slides stained by hematoxylin-eosin. Statistical analysis was performed with MedCalc software 14.8.1.
Results: From 2001 to 2012, n=86 cases with PVR for PDAC, long-term follow-up and sufficient tissue for re-assessment were identified. Histopathological re-review disclosed true cancerous portal vein wall invasion (PVI) in 39 resection specimen. Patients with and without PVI did not differ in baseline demographic and standard histopathological parameters except for a significant association of PVI with hemangiosis and positive margin status. Overall survival was 22 months. Only lymph node ratio and PVI were univariate and multivariately independent predictors of survival after resection. Without PVI, median survival was 11 months longer than with PVI (p=0.042).
Conclusion: If technically feasible, PVR should be performed routinely in case of PDAC adhesion to the portal vein. Survival in this situation is influenced by lymph node ratio and confirmed histopathologic invasion of the portal vein wall.
Figure 1 [Fig. 1]