Results of pancreaticoduodenectomy with portal or superior mesenteric vein resection for locally advanced pancreatic head cancer.
OBJECTIVE
It is known that portal vein (PV) or superior mesenteric vein (SMV) is easily invaded by locally advanced pancreatic head cancer due to anatomical characteristics. Few studies have investigated the results of PD with PV or SMV resection (PVR) for pancreatic head cancer.


METHODS
We retrospectively reviewed a database of 83 patients who had undergone PD for pancreatic head cancer (PC). We divided them into two groups, a group with PD and PVR (PD +PVR G) and a group with PD and no PVR (PD -PVR G). The clinicopathological findings and mortality were analyzed.


RESULTS
Twenty-nine of the 83 patients (34.9%) needed PD with PVR. Median survival and disease free survival were 20.4 months and 10.6 months, respectively. The 5-year overall survival rate was 8.1% in PD +PVR G and 7.4% in PD -PVR G, respectively. There was no difference between the two groups (p = 0.091, HR: 1.576; 95% CI: 0.9299-2.670). The 5-year disease free survival rate was 9.6% in PD +PVR G and 10.2% in PD -PVR G, respectively. Also, there was no difference between the two groups (p = 0.206, HR: 1.414; 95% CI: 0.8264-2.420).


CONCLUSIONS
Since PVR by itself is not a risk factor of postoperative morbidity and mortality and contributes to improving 5-year overall survival and disease free survival, PVR should be done for selected cases with locally advanced pancreas head cancer.
Mitsugi
M
Shimoda
Shozo
S
Mori
Junji
J
Kita
Tokihiko
T
Sawada
Keiichi
K
Kubota
D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality