Callie A. Hlavin, Sebastiaan Ceuppens, Nikhil Tirukkovalur, Jiage Qian, Aatur D. Singhi, Nathan Cook, Ibrahim Nassour, Kenneth K. Lee, Amer H. Zureikat, Alessandro Paniccia
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Patients were categorized into three groups: R0 resection (tumor > 1 mm from all margins, <i>n</i> = 168), VG+ without vein invasion (+VGnoVI, <i>n</i> = 66), and positive vein involvement with direct tumor invasion into the vein wall (+VGwithVI) (<i>n</i> = 13). Kaplan-Meier estimates assessed OS and DFS, while multivariable analyses identified recurrence and survival predictors.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>+VGnoVI group showed higher rates of local recurrence (OR 2.68, <i>p</i> = 0.002) compared to the R0 group. However, no significant differences were observed in DFS (R0: 17 months; +VGnoVI: 18 months; +VGwithVI: 21 months, <i>p</i> = 0.68) or OS (R0: 27 months; +VGnoVI: 29 months; +VGwithVI: 30 months, <i>p</i> = 0.98) across groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>A positive vascular groove, whether isolated or associated with vein invasion, does not compromise OS or DFS compared to R0 resections.</p>\n </section>\n </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 4","pages":"684-694"},"PeriodicalIF":1.9000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.70052","citationCount":"0","resultStr":"{\"title\":\"Implications of an Isolated Positive Vascular Groove After Whipple for Pancreatic Adenocarcinoma: A Single Institution, Retrospective Analysis\",\"authors\":\"Callie A. 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引用次数: 0
摘要
背景和目的：血管沟（VG）不再被认为是切除边缘，而是受病灶表面。孤立VG+的临床意义仍有争议。因此，本研究评估了分离VG+，无论是否切除静脉，对胰十二指肠切除术（PD）治疗胰管腺癌（PDAC）后总生存期（OS）和无病生存期（DFS）的影响。方法：对2006-2019年247例患者进行回顾性分析。患者分为三组：R0切除组（肿瘤距所有边缘0.1 mm, n = 168）， VG+无静脉侵犯组（+VGnoVI, n = 66），静脉阳性累及肿瘤直接侵犯静脉壁组（+VGwithVI） （n = 13）。Kaplan-Meier估计评估OS和DFS，而多变量分析确定复发和生存预测因子。结果：+VGnoVI组局部复发率高于R0组（OR 2.68, p = 0.002）。然而，两组在DFS方面无显著差异(R0: 17个月；+VGnoVI: 18个月；+VGwithVI: 21个月，p = 0.68)或OS (R0: 27个月；+VGnoVI: 29个月；+VGwithVI: 30个月，p = 0.98)。结论：与R0切除相比，阳性血管沟，无论是孤立的还是与静脉侵犯相关的，都不会影响OS或DFS。
Implications of an Isolated Positive Vascular Groove After Whipple for Pancreatic Adenocarcinoma: A Single Institution, Retrospective Analysis
Background and Objective
The vascular groove (VG) is no longer considered a resection margin but rather a surface of involvement. The clinical significance of an isolated VG+ remains debated. Therefore, this study evaluates the impact of isolated VG+, with or without vein resection, on overall survival (OS) and disease-free survival (DFS) following pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).
Methods
A retrospective analysis of 247 patients (2006–2019) was conducted. Patients were categorized into three groups: R0 resection (tumor > 1 mm from all margins, n = 168), VG+ without vein invasion (+VGnoVI, n = 66), and positive vein involvement with direct tumor invasion into the vein wall (+VGwithVI) (n = 13). Kaplan-Meier estimates assessed OS and DFS, while multivariable analyses identified recurrence and survival predictors.
Results
+VGnoVI group showed higher rates of local recurrence (OR 2.68, p = 0.002) compared to the R0 group. However, no significant differences were observed in DFS (R0: 17 months; +VGnoVI: 18 months; +VGwithVI: 21 months, p = 0.68) or OS (R0: 27 months; +VGnoVI: 29 months; +VGwithVI: 30 months, p = 0.98) across groups.
Conclusions
A positive vascular groove, whether isolated or associated with vein invasion, does not compromise OS or DFS compared to R0 resections.
期刊介绍：
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.
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