Arterial and Venous Resection for Pancreatic Adenocarcinoma

Martin, Robert C.

doi:10.1001/archsurg.2008.547

Cited by 160 publications

(117 citation statements)

References 19 publications

(26 reference statements)

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…By excluding the first series with regional pancreatectomy, vein resection does not have prognostic significance regarding the survival. Large series with radical surgical resection showed that surgical morbidity and mortality rates are comparable to standard pancreatic head resections [38][39][40]. Comparable complication rates between standard pancreaticoduodenectomy (PD) and pancreaticoduodenectomy with vascular resection (PDVR) were reported by some studies [12,13].…”

Section: Outcomementioning

confidence: 98%

The Role of Vascular Resection in Pancreatic Cancer Treatment

Vladov¹,

Takorov²,

Lukanova³

2017

Challenges in Pancreatic Pathology

View full text Add to dashboard Cite

Currently, porto-mesenteric vein resection is a standard procedure at high-volume pancreatic centers. Experience in vascular surgery is indispensable for a modern pancreatic surgeon. Nowadays, only arterial resections still are a controversial issue. Nevertheless, attempts at resection involving reconstruction of the main arteries such as the coeliac axis, hepatic artery, and superior mesenteric artery (SMA) have been reported, although in small case series. An overview of the historical and contemporary methods for surgical management of superior mesenteric/portal vein involvement as well as arterial involvement by pancreatic cancer is presented. We compare the data from the literature with our data based on the examination and long-term follow-up of more than 300 radical pancreatic resections. Seventy-two of the presented patients underwent pancreatic resection with simultaneous vascular resection-SMPV in 65 cases (44 with resection of the portal vein, 15 with resection of the superior mesenteric vein, 6 with resection of the portomesenterial confluence), arterial in 2 and partial resections of IVC in 5 cases. Combined vascular resections were done in three cases. Both groups PVR and PR showed similarly close results in complication rates, mortality, and morbidity. Three and 5 years survival rates were 42 and 38% in PD group and 28 and 19% in the PVR group. The vascular resection must be performed only upon carefully selected patients with data for presence of resectable tumors or tumors with borderline resectability from the preoperative imaging studies. The prompt management of pancreatic cancer with vascular involvement should involve multidisciplinary consultation in high-volume centers.

show abstract

Section: Outcomementioning

confidence: 98%

The Role of Vascular Resection in Pancreatic Cancer Treatment

Vladov¹,

Takorov²,

Lukanova³

2017

Challenges in Pancreatic Pathology

View full text Add to dashboard Cite

show abstract

“…Studies from high-volume centers, containing selected patients have shown similar morbidity, mortality, and survival rates if a margin-negative resection was performed [79][80][81]. A systematic review concluded that venous resection is a safe and feasible procedure that increases the number of patients who can undergo curative resection and, therefore, may provide important survival benefits to selected groups of patients [82].…”

Section: Vascular Resectionmentioning

confidence: 99%

“…Highvolume centers, with expertise in en bloc resection of the hepatic artery, superior mesenteric artery, or even the celiac trunk itself [86][87][88] have shown good survival outcomes.…”

Section: Vascular Resectionmentioning

confidence: 99%

Improving Survival of Pancreatic Cancer. What Have We Learnt?

Singh

Chaudhary

2015

Indian J Surg

View full text Add to dashboard Cite

Pancreatic adenocarcinoma still ranks high among cancer-related deaths worldwide. In spite of substantial strides in preoperative staging, surgery, perioperative care, and adjuvant treatment, the survival still remains dismal. A number of patient-, disease-, and surgeon-related factors play a role in deciding the eventual outcome of the patient. The aim of this commentary is to review the current knowledge of various factors and the recent advances that impact the survival of patients with pancreatic adenocarcinoma. A search of scientific literature using Embase and MEDLINE, for the years 1985-2015, was carried out for search terms Bpancreatic cancer^and Bsurvival.^Further search was based on the various specific prognostic factors that contribute towards survival of patients with pancreatic cancer found in the literature. Most of the studies used for this review include those that deal with pancreatic head cancers, some include patients with pancreatic cancers in all locations while very few included patients with tumors of body and tail only. In spite of significant developments in pre-and perioperative management, increased rates of margin-negative resections, and use of adjuvant treatment, the survival rates of pancreatic cancer patients remains poor. A paradigm shift with more effective adjuvant regimen and genetic interventions may help change the outcomes of patients with pancreatic cancer.

show abstract

“…Thus, a small portion of portal vein encroachment may be considered resectable in most, but not all centres dealing with these cancers [40,41]. However, arterial involvement is considered operable only by a minority of the centres of excellence and, even in those series of patients, the peri-operative outcome is not good [41,42].…”

Section: Post-test Variabilitymentioning

confidence: 99%