Academic Journal
Portal-Mesenteric Vein Resection in Borderline Pancreatic Cancer; 33 Month-Survival in Patients with Good Performance Status
| العنوان: | Portal-Mesenteric Vein Resection in Borderline Pancreatic Cancer; 33 Month-Survival in Patients with Good Performance Status |
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| المؤلفون: | Gregory G. Tsiotos, Nikiforos Ballian, Theodoros Michelakos, Fotios Milas, Panoraia Ziogou, Dimitrios Papaioannou, Charitini Salla, Ilias Athanasiadis, Evangelia Razis, Flora Stavridi, Maria Psomas |
| المصدر: | Journal of Pancreatic Cancer, Vol 5, Iss 1, Pp 43-50 (2019) |
| بيانات النشر: | Mary Ann Liebert |
| سنة النشر: | 2019 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | borderline pancreatic cancer, locally advanced pancreatic cancer, mesenteric vein resection, pancreaticoduodenectomy, portal vein resection, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | Background: Patients with pancreatic cancer (PC), which is not upfront resectable, but borderline, involving major peripancreatic vessels, have not been generally considered for surgery, considering that resection in such a setting may be futile. Materials and Methods: Retrospective analysis of prospectively collected data on patients with borderline pancreatic adenocarcinoma undergoing pancreatectomy en-block with portal and/or superior mesenteric vein resection in a tertiary referral center in Greece between January 2012 and February 2017. Follow-up was complete up to January 2018. Results: Twenty-four patients were included. Neoadjuvant therapy (NAT) was administered to only 38%, but more commonly in the second half of the group (58% vs. 17%, p = 0.035). It was associated with smaller tumor size (median: 2.5 vs. 4.2 cm, p < 0.001), fewer positive lymph nodes (LNs) in the resected specimen (median: 2 vs. 5, p = 0.04), and higher likelihood of adjuvant therapy (78% vs. 40%, p = 0.01), but not with survival. Resection was extensive: a median of 26 LNs were retrieved, R0 resection rate (≥1 mm) was 79%, and median length of vein segments was 4 cm, requiring interposition grafts in 58% (mostly polytetrafluoroethylene). Median intensive care unit stay was 0 days and length of hospital stay was 9 days. Post-operative mortality was 12.5%. Median overall survival was 24 months. Eastern Cooperative Oncology Group (ECOG) status was significantly associated with survival (p < 0.001) with ECOG-0: 33 months, ECOG-1: 12 months, and ECOG-2: 6 months. Conclusion: This first Greek national series of portomesenteric vein resection in borderline PC demonstrates that it results to 2 years of median survival, extending to 33 months in patients with good performance status, especially if NAT is uniformly administered. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2475-3246 |
| Relation: | https://doaj.org/toc/2475-3246; https://doaj.org/article/915140f38320495fa297fbfda8a065e4 |
| DOI: | 10.1089/PANCAN.2019.0013 |
| الاتاحة: | https://doi.org/10.1089/PANCAN.2019.0013 https://doaj.org/article/915140f38320495fa297fbfda8a065e4 |
| رقم الانضمام: | edsbas.1E5D1423 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 24753246 |
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| DOI: | 10.1089/PANCAN.2019.0013 |