title: Outcomes of resections for pancreatic adenocarcinoma with suspected venous involvement: a single center experience.
abstract: BACKGROUND
  Pancreatic ductal adenocarcinoma (PDAC) patients frequently present with borderline resectable disease, which can be due to invasion of the portal/superior mesenteric vein (PV/SMV). Here, we analyzed this group of patients, with emphasis on short and long-term outcomes.
  
  
  METHODS
  156 patients who underwent a resection for PDAC were included in the analysis and sub-stratified into a cohort of patients with PV/SMV resection (n = 54) versus those with standard surgeries (n = 102).
  
  
  RESULTS
  While venous resections could be performed safely, there was a trend towards shorter median survival in the PV/SMV resection group (22.7 vs. 15.8 months, p = 0.157). These tumors were significantly larger (3.5 vs. 4.3 cm; p = 0.026) and margin-positivity was more frequent (30.4% vs. 44.4%, p = 0.046).
  
  
  CONCLUSIONS
  Venous resection was associated with a higher rate of margin positivity and a trend towards shorter survival. However, compared to non-surgical treatment, resection offers the best chance for long term survival.
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.|Current address: Department of Surgery, University of Heidelberg, Heidelberg, Germany.
authors: Christoph W
authors: CW
authors: Michalski
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors: Bo
authors: B
authors: Kong
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors: Carsten
authors: C
authors: Jäger
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors: Silke
authors: S
authors: Kloe
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors: Barbara
authors: B
authors: Beier
authors: Institute of Radiology, Technische Universität München, Munich, Germany.
authors: Rickmer
authors: R
authors: Braren
authors: Institute of Pathology, Technische Universität München, Munich, Germany.|Current address: Institute of Pathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors: Irene
authors: I
authors: Esposito
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.|Current address: Department of Surgery, Koc University School of Medicine, Istanbul, Turkey.
authors: Mert
authors: M
authors: Erkan
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany.
authors: Helmut
authors: H
authors: Friess
authors: Department of Surgery, Technische Universität München, Ismaningerstrasse 22, 81675, Munich, Germany. kleeff@tum.de.
authors: Jorg
authors: J
authors: Kleeff
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome