胰体/尾癌累及门静脉对预后的影响:日本肝胆胰外科学会项目研究

IF 2.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
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
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引用次数: 0

摘要

背景:虽然胰体/尾导管腺癌(PbtCa)的门静脉(PV)接触≤180°是可切除的标准,但尚未建立足够的证据。方法:本回顾性研究分析了日本31家机构的1693例行远端胰腺切除术的PbtCa患者。比较非PV接触组、PV接触组和腹腔轴(CeA)接触组的临床病理因素、生存率和复发模式。结果:PV接触者(n = 168)的总生存期(MST: 28.3个月)和手术切缘阳性率(23%)比非PV接触者(n = 1353, 47.9个月)差[p]结论:PV接触者的PbtCa与CeA接触者相似,手术切缘阳性率高,生存率差,应考虑边缘可切除。试验注册:本研究已在UMIN临床试验注册中心注册(UMIN- ctr: UMIN000041642)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prognostic Impact of Pancreatic Body/Tail Cancer Involving the Portal Vein: A Project Study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery

Prognostic Impact of Pancreatic Body/Tail Cancer Involving the Portal Vein: A Project Study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery

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)

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
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.
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