title: Invasion of the splenic artery is a crucial prognostic factor in carcinoma of the body and tail of the pancreas.
abstract: OBJECTIVE
  A retrospective study was performed to determine the prognostic implications of invasion to the splenic vessels in pancreatic body and tail cancer.
  
  
  BACKGROUND
  Involvement of the splenic artery (SA) and vein (SV) is frequently observed in carcinoma of the body and tail of the pancreas, but its correlation with various other clinicopathologic factors and prognosis has not been explored in detail.
  
  
  METHODS
  Fifty-one patients who had undergone distal pancreatectomy for invasive adenocarcinoma of the body and tail of the pancreas were discreetly selected from the prospective data base for analyses. Cases that required extended surgery due to invasion of the major vessels such as the portal vein, common hepatic artery, celiac artery, and superior mesenteric artery were excluded. Correlation between invasion of the splenic vessels and prognosis and other clinicopathologic factors were analyzed.
  
  
  RESULTS
  Seventeen patients with invasion of the SA had a significantly inferior prognosis compared with those without the invasion (P = 0.0067), whereas invasion of the SV, observed in 24 patients, did not affect prognosis. Additionally, invasion of the SA significantly correlated with tumor size > or = 2 cm, anterior serosal infiltration, perineural invasion and SV invasion (P = 0.0440, P = 0.0406, P = 0.0460, and P = 0.0173, respectively). In univariate analysis, SA invasion, lymph node metastasis, and anterior serosal infiltration were identified as significant poor prognostic factors. In multivariable analysis, only SA invasion was an independent prognostic factor (odds ratio, 2.611, P = 0.0196).
  
  
  CONCLUSIONS
  Our results indicated that the invasion of the SA, but not that of the SV, is a crucial prognostic factor in pancreatic body and tail cancer.
authors.affiliation: Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Mitsuro
authors.initials: M
authors.lastname: Kanda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fujii
authors.forename: Tevfik T
authors.initials: TT
authors.lastname: Sahin
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Kanzaki
authors.forename: Shunji
authors.initials: S
authors.lastname: Nagai
authors.forename: Suguru
authors.initials: S
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Nomoto
authors.forename: Shin
authors.initials: S
authors.lastname: Takeda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D013157:Splenic Artery; D019043:Vascular Neoplasms / Q000473:pathology*