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Benefit of portal or superior mesenteric vein resection with adjuvant chemotherapy for patients with pancreatic head carcinoma
Author(s) -
Murakami Yoshiaki,
Uemura Kenichiro,
Sudo Takeshi,
Hashimoto Yasushi,
Nakashima Akira,
Kondo Naru,
Nakagawa Naoya,
Sueda Taijiro
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23229
Subject(s) - medicine , superior mesenteric vein , surgery , pancreaticoduodenectomy , univariate analysis , carcinoma , multivariate analysis , chemotherapy , pathological , portal vein , resection
Background and Objectives The aim of this study was to evaluate the efficacy of portal or superior mesenteric vein (PV/SMV) resection for patients with pancreatic carcinoma who underwent pancreatoduodenectomy. Methods Medical records of 125 patients with pancreatic head carcinoma who underwent pancreatoduodenectomy were reviewed retrospectively. Sixty‐one patients underwent PV/SMV resection and 64 patients did not. Clinicopathological factors were compared between the two groups and the prognostic impact of PV/SMV resection was evaluated using univariate and multivariate survival analysis. Results The frequency of mortality and morbidity did not differ between the two groups. Univariate analysis revealed that a significant difference in overall survival was found between patients who did and did not undergo PV/SMV resection ( P = 0.046) as well as between patients with and without pathological PV/SMV invasion ( P = 0.012). However, PV/SMV resection and pathological PV/SMV invasion were not independent prognostic factors by multivariate survival analysis. Among patients with PV/SMV resection, the use of adjuvant chemotherapy was the only independent prognostic factor of overall survival ( P = 0.003). Conclusions Resection of the PV/SMV with adjuvant chemotherapy may provide an acceptable survival benefit to patients with pancreatic head carcinoma, which involves the PV/SMV without additional mortality and morbidity. J. Surg. Oncol. 2013;107:414–421. © 2012 Wiley Periodicals, Inc.