Prognostic Impact of Pancreatic Body/Tail Cancer Involving the Portal Vein: A Project Study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery
{"title":"Prognostic Impact of Pancreatic Body/Tail Cancer Involving the Portal Vein: A Project Study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery","authors":"Yusuke Yamamoto, Teiichi Sugiura, Ryota Higuchi, Satoshi Hirano, Masayuki Sho, Yasuhiro Shimizu, Masayuki Ohtsuka, Manabu Kawai, Kenichiro Uemura, Takeshi Gocho, Hidehiro Tajima, Koji Amaya, Hiroyuki Ishizu, Minoru Tanabe, Katsutoshi Murase, Atsushi Nanashima, Takashi Aono, Toshiki Rikiyama, Shigeru Marubashi, Makoto Murakami, Chie Kitami, Isaku Yoshioka, Masaji Tani, Yoshihiro Sakamoto, Tomonari Ishimine, Hidetoshi Eguchi, Teruyuki Usuba, Mitsuhisa Takatsuki, Hideki Aoki, Makoto Yoshida, Kazuaki Nakanishi, Eigo Otsuji, Katsuhiko Uesaka, Masafumi Nakamura, Itaru Endo","doi":"10.1002/jhbp.12177","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Although portal vein (PV) contact ≤ 180° in pancreatic body/tail ductal adenocarcinoma (PbtCa) is a criterion for resectable, adequate evidence has not been established yet.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study analyzed 1693 patients with PbtCa who underwent distal pancreatectomy across 31 institutions in Japan. Clinicopathological factors, survival, and recurrence pattern were compared among non-PV contact, PV contact, and celiac axis (CeA) contact groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall survival (MST: 28.3 months) and the positive surgical margin rate (23%) in the PV contact (<i>n</i> = 168) were worse than those of non-PV contact (<i>n</i> = 1353, 47.9 months [<i>p</i> < 0.001], 13% [<i>p</i> = 0.001]), and were comparable with CeA contact (<i>n</i> = 172, 26.4 months [<i>p</i> = 0.136], 26% [<i>p</i> = 0.447]). Incidence of local recurrence (26%) and peritoneal recurrence (20%) in the PV contact were comparable to those in the CeA contact (21%, <i>p</i> = 0.309, and 19%, <i>p</i> = 0.915). Cox proportional hazards analysis revealed PV contact (hazard ratio, 1.295; <i>p</i> = 0.003) as independent prognostic factors for overall survival.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>PbtCa with PV contact should be considered borderline resectable because of a high positive surgical margin rate and poor survival, similar to those in PbtCa with CeA contact.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>This study was registered in the UMIN Clinical Trial Registry (UMIN-CTR: UMIN000041642)</p>\n </section>\n </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 9","pages":"656-666"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12177","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Although portal vein (PV) contact ≤ 180° in pancreatic body/tail ductal adenocarcinoma (PbtCa) is a criterion for resectable, adequate evidence has not been established yet.
Methods
This retrospective study analyzed 1693 patients with PbtCa who underwent distal pancreatectomy across 31 institutions in Japan. Clinicopathological factors, survival, and recurrence pattern were compared among non-PV contact, PV contact, and celiac axis (CeA) contact groups.
Results
Overall survival (MST: 28.3 months) and the positive surgical margin rate (23%) in the PV contact (n = 168) were worse than those of non-PV contact (n = 1353, 47.9 months [p < 0.001], 13% [p = 0.001]), and were comparable with CeA contact (n = 172, 26.4 months [p = 0.136], 26% [p = 0.447]). Incidence of local recurrence (26%) and peritoneal recurrence (20%) in the PV contact were comparable to those in the CeA contact (21%, p = 0.309, and 19%, p = 0.915). Cox proportional hazards analysis revealed PV contact (hazard ratio, 1.295; p = 0.003) as independent prognostic factors for overall survival.
Conclusions
PbtCa with PV contact should be considered borderline resectable because of a high positive surgical margin rate and poor survival, similar to those in PbtCa with CeA contact.
Trial Registration
This study was registered in the UMIN Clinical Trial Registry (UMIN-CTR: UMIN000041642)
期刊介绍:
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.