Pancreatoduodenectomy without Vascular Resection in Patients with Primary Resectable Adenocarcinoma and Unilateral Venous Contact: A Matched Case Study
Joint Authors
Morelli, Luca
Berchiolli, Raffaella
Guadagni, Simone
Palmeri, Matteo
Furbetta, Niccolò
Gianardi, Desirée
Bianchini, Matteo
Caprili, Giovanni
Pollina, Luca Emanuele
Di Candio, Giulio
Mosca, Franco
Di Franco, Gregorio
Cuschieri, A.
Funel, Niccola
Source
Gastroenterology Research and Practice
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-11-25
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Purpose.
To investigate the oncological outcome and survival of patients following a conservative approach on the portal-mesenteric axis, in an intraoperative ultrasound-selected group of pancreatoduodenectomy (PD), performed on patients with primary resectable with vascular contact (prVC) pancreatic ductal adenocarcinoma (PDAC).
Methods.
A consecutive series of patients who underwent PD for PDAC at our tertiary care center, between 2008 and 2017, were reviewed.
A total of 156 PDs and 88 total pancreatectomies were performed during the study period, including 35 vascular resections.
We identified a group of 40 (25.6%) patients with prVC-PDAC in whom after checking the feasibility with intraoperative ultrasound, we were able to perform PD by separation of the tumor from the portomesenteric axis avoiding vascular resection, without residual macroscopic disease (no vascular resection, nvrPD), and compared this group, using case-matched methodology, with the standard PD (sPD) group of primary resectable without vascular contact- (prwVC-) PDAC.
Results.
The median follow-up was 28.5 ± 23.2 months in the sPD group and 23.8 ± 20.8 months in the nvrPD group (p=0.35).
Isolated local recurrence rate was 2/40 (5%) in both groups.
Additionally, there were no statistical differences in the systemic progression of the disease (42.5% sPD vs.
45% nvrPD, p=0.82) or local plus synchronous systemic disease rates (2.5% sPD vs.
7.5% nvrPD, p=0.30).
The median survival was 22 months for the sPD group and 23 months for the nvrPD group, p=0.86.
The overall survival was similar in the two groups (1 y: 76.3% sPD vs.
70.0% nvrPD; 3 y: 35.6% vs.
31.6%; and 5 y: 28.5% vs.
25.3%; p=0.80).
Conclusions.
PD without vascular resection can be considered safe and oncologically acceptable in selected patients with preoperative diagnosis of prVC-PDAC.
The poor prognosis of PDAC is related to the aggressive biology and systemic spread of the tumor, rather than the local control of the disease.
American Psychological Association (APA)
Morelli, Luca& Berchiolli, Raffaella& Guadagni, Simone& Palmeri, Matteo& Furbetta, Niccolò& Gianardi, Desirée…[et al.]. 2018. Pancreatoduodenectomy without Vascular Resection in Patients with Primary Resectable Adenocarcinoma and Unilateral Venous Contact: A Matched Case Study. Gastroenterology Research and Practice،Vol. 2018, no. 2018, pp.1-8.
https://search.emarefa.net/detail/BIM-1159221
Modern Language Association (MLA)
Morelli, Luca…[et al.]. Pancreatoduodenectomy without Vascular Resection in Patients with Primary Resectable Adenocarcinoma and Unilateral Venous Contact: A Matched Case Study. Gastroenterology Research and Practice No. 2018 (2018), pp.1-8.
https://search.emarefa.net/detail/BIM-1159221
American Medical Association (AMA)
Morelli, Luca& Berchiolli, Raffaella& Guadagni, Simone& Palmeri, Matteo& Furbetta, Niccolò& Gianardi, Desirée…[et al.]. Pancreatoduodenectomy without Vascular Resection in Patients with Primary Resectable Adenocarcinoma and Unilateral Venous Contact: A Matched Case Study. Gastroenterology Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-8.
https://search.emarefa.net/detail/BIM-1159221
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1159221