title: National Comprehensive Cancer Network Resectability Status for Pancreatic Carcinoma Predicts Overall Survival.
abstract: BACKGROUND
  The aim of this study was to evaluate the validity of preoperative resectability status, as defined by the National Comprehensive Cancer Network (NCCN), from the viewpoint of overall survival.
  
  
  METHODS
  A total of consecutive 704 patients with pancreatic head carcinoma who underwent pancreatoduodenectomy with upfront surgery at seven Japanese hospitals between 2001 and 2012 were evaluated retrospectively. According to the NCCN definition of preoperative resectability status, tumors were divided into resectable tumors without vascular contact (R group), resectable tumors with portal or superior mesenteric vein (PV/SMV) contact of ≦180° (R-PV group), borderline resectable(BR) tumors with PV/SMV contact of >180° (BR-PV group), and BR tumors with arterial contact (BR-A group). The relationship between the NCCN definition of preoperative resectability status and overall survival was analyzed.
  
  
  RESULTS
  Of the 704 patients, 389, 114, 145, and 56 were classified into the R group, the R-PV group, the BR-PV group, and the BR-A group, respectively. Overall survival of the BR-PV and BR-A groups was significantly worse than that of the R group and R-PV groups (P < 0.05), although there was no significant difference in overall survival between the R group and the R-PV group (P = 0.310). Multivariate analysis revealed that PV/SMV contact of >180° (P = 0.008) and arterial contact (P < 0.001) were independent prognostic factors of overall survival.
  
  
  CONCLUSIONS
  From the viewpoint of overall survival, the NCCN definition of preoperative resectability status was valid.
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan, mura777@hiroshima-u.ac.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Sohei
authors.initials: S
authors.lastname: Satoi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yanagimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Masanao
authors.initials: M
authors.lastname: Kurata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome