title: Is the need for an arterial resection a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma? A case-matched controlled study.
abstract: OBJECTIVE
  Arterial resection (AR) has traditionally been considered as a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma. The objective was to evaluate if pancreatic resection with AR was worthwhile.
  
  
  METHODS
  Between January 1990 and December 2008 the records of 26 consecutive patients who underwent a curative-intent pancreatic resection for adenocarcinoma of the pancreas with AR (AR+ group) were matched 1:1 to those of the whole series of pancreatic resection performed in our institution. The final study population (n = 52) included two groups of patients: the study group AR+ = 26 and the control group AR- = 26.
  
  
  RESULTS
  The 1- and 3-year survival rates were similar in the two groups (65.9% and 22.1%, median 17 months for the group AR + , versus 50.0% and 17.6%, median 12 months, for the group AR-; P = 0.581). The multivariate analysis showed that: arterial wall invasion at the site of AR, the total number of resected lymph nodes of ≤15, and perineural invasion were independent prognostic factors for survival.
  
  
  CONCLUSIONS
  Pancreatic resections with AR for adenocarcinoma allowed to obtain a 3-survival rate similar to that of a matched group of patients not requiring AR.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaires de Strasbourg, CHU Hautepierre, Strasbourg Cedex, France. Philippe.Bachellier@chru-strasbourg.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Ionut
authors.initials: I
authors.lastname: Lucescu
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Jacky
authors.initials: J
authors.lastname: Tracey
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Nelio
authors.initials: N
authors.lastname: Ferreira
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002445:Celiac Artery / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome