Reassessment of the clinical significance of portal–superior mesenteric vein invasion in borderline resectable pancreatic cancer

Hoshimoto, Sojun; Hishinuma, Shoichi; Soejima, Hirofumi; Tomikawa, Moriaki; Ozawa, Iwao; Wakamatsu, Saho; Hoshi, Seiji; Hoshi, Nobuo; Hirabayashi, Kaoru; Ogata, Yoshiro

doi:10.1016/j.ejso.2017.03.020

Cited by 25 publications

(26 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After removal of 690 duplicates, a further 2588 articles were excluded after title and abstract screening because they did not meet the prespecified inclusion criteria. The full texts of the remaining 468 studies were evaluated in more detail, and 89 studies were found to meet the eligibility criteria for this systematic review. Among them, 22 studies containing information on clinical factors relevant to recurrence sites were selected for the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The Cochrane Collaboration tool for assessing risk of bias showed that one study had no domain with a high risk of bias and three studies had one of seven domains with a high risk of bias ( Table S3 , supporting information). The overall risk of bias in non‐randomized studies, according to ROBINS‐I, was moderate in 48 studies and serious in 37 studies ( Table S4 , supporting information).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Tanaka

Mihaljevic

Probst

et al. 2019

British Journal of Surgery

137

View full text Add to dashboard Cite

Background: Initial recurrence mapping of resected pancreatic ductal adenocarcinoma (PDAC) could help in stratifying patient subpopulations for optimal postoperative follow-up. The aim of this systematic review and meta-analysis was to investigate the initial recurrence patterns of PDAC and to correlate them with clinicopathological factors.Methods: MEDLINE and Web of Science databases were searched systematically for studies reporting first recurrence patterns after PDAC resection. Data were extracted from the studies selected for inclusion. Pooled odds ratios (ORs) and 95 per cent confidence intervals were calculated to determine the clinicopathological factors related to the recurrence sites. The weighted average of median overall survival was calculated.Results: Eighty-nine studies with 17 313 patients undergoing PDAC resection were included. The weighted median rates of initial recurrence were 20⋅8 per cent for locoregional sites, 26⋅5 per cent for liver, 11⋅4 per cent for lung and 13⋅5 per cent for peritoneal dissemination. The weighted median overall survival times were 19⋅8 months for locoregional recurrence, 15⋅0 months for liver recurrence, 30⋅4 months for lung recurrence and 14⋅1 months for peritoneal dissemination. Meta-analysis revealed that R1 (direct) resection (OR 2⋅21, 95 per cent c.i. 1⋅12 to 4⋅35), perineural invasion (OR 5⋅19, 2⋅79 to 9⋅64) and positive peritoneal lavage cytology (OR 5⋅29, 3⋅03 to 9⋅25) were significantly associated with peritoneal dissemination as initial recurrence site. Low grade of tumour differentiation was significantly associated with liver recurrence (OR 4⋅15, 1⋅71 to 10⋅07).

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Tanaka

Mihaljevic

Probst

et al. 2019

British Journal of Surgery

137

View full text Add to dashboard Cite

show abstract

“…The present results are also in agreement with the study of Ohgi and co-workers 10 , who reported similar postoperative survival in patients with resectable and those with BR-PV PDAC according to CT findings, with median survival of 20⋅7 and 18⋅6 months respectively. Hoshimoto et al 14 also showed comparable survival in patients with BR-PV and those with resectable PDAC. All three studies, including the present one, that showed comparable survival included only 21-39 patients with borderline resectable PDAC.…”

Section: Discussionmentioning

confidence: 83%

“…The accuracy of CT in predicting pathological PV invasion (pPV) and postoperative prognosis is low , . In the authors' institution, PVR is indicated only when the pancreatic head cannot be detached from the PV during PD.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of resecting the portal vein only when necessary during pancreatoduodenectomy for pancreatic cancer

et al. 2019

View full text Add to dashboard Cite

Background Whether the portal/superior mesenteric vein (PV) should be resected during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) based on preoperative CT or intraoperative findings is controversial. Methods This was a retrospective study with data of patients who had undergone pancreatoduodenectomy for PDAC between 2002 and 2016 in a tertiary referral centre. Based on the extent of contact between the PV and tumour on CT, patients were categorized into: group 1, no contact; group 2, contact 180° or less; group 3, contact greater than 180°. Extent of pathological PV invasion (pPV) (no invasion, pv0; invasion to tunica adventitia, pv1; invasion to media, pv2; invasion to intima, pv3) was compared with patient survival. To assess the feasibility of performing PV resection (PVR) based on intraoperative findings, the prognosis of patients in groups 1 and 2 with pv0 and no PVR (PVR(−)pv0) was compared with that of patients who had PVR (PVR(+)pv0), selected using propensity score matching. Results Groups 1, 2 and 3 comprised 230, 232 and 38 patients respectively, and PVR was performed in 10·9, 73·3 and 95 per cent of them ( P < 0·001). Extent of pPV differed significantly ( P < 0·001). The positive predictive value of radiological tumour contact with PV in predicting positive pPV was 42·6 per cent. In 64 patients with PVR(−)pv0 and 64 matched patients with PVR(+)pv0, the R0 resection rate (66 versus 73 per cent respectively; P = 0·337) and survival (median 32·4 versus 32·1 months; P = 0·780) were not significantly different. Conclusion PVR is needed only when the tumour is in clear contact with the PV and cannot be detached during surgery.

show abstract

“…6.4. The extent of tumor invasion (grades 1: adventitia, 2: media, and 3: intima) described by Nakao (18) is often poorly evaluated and the prognostic value of this feature is also debated (82,87,89,90,93), including after neoadjuvant treatment (92, 94) (LE 4). In the series by Roch et al (93), the 3 grades of tumor invasion had no significant impact on overall or disease-free survival (14.4 vs. 15.5 vs. 7.4 months, p = 0.08 and 11.2 vs. 12.2 vs. 5 months, p = 0.59, respectively), although survival was very short in case of intra-luminal tumor invasion (however, the number of patients was low) (LE 4).…”

Section: Impact Of the Reconstruction Technique On The Long-term Permmentioning

confidence: 99%

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

Delpero

Sauvanet

2020

Front. Oncol.

View full text Add to dashboard Cite

Reassessment of the clinical significance of portal–superior mesenteric vein invasion in borderline resectable pancreatic cancer

Cited by 25 publications

References 24 publications

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Feasibility of resecting the portal vein only when necessary during pancreatoduodenectomy for pancreatic cancer

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

Contact Info

Product

Resources

About