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01-12-2024 | Research

Impact of radiological and pathological splenic vein involvement in patients with resectable pancreatic body or tail cancer

Authors: Naohisa Kuriyama, Shugo Mizuno, Tatsuya Sakamoto, Yu Fujimura, Takuya Yuge, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Akihiro Tanemura, Motonori Nagata, Miki Usui, Masashi Kishiwada

Published in: Langenbeck's Archives of Surgery | Issue 1/2024

Abstract

Purpose

Several studies have reported a negative impact on survival associated with splenic vessel involvement, especially splenic artery (SpA) involvement, in patients diagnosed with pancreatic body or tail cancer. However, there is limited research on splenic vein (SpV) involvement. Therefore, we aimed to elucidate the significance of splenic vessel involvement, especially SpV involvement, in patients with resectable pancreatic body or tail cancer.

Methods

Between January 2007 and December 2021, 116 consecutive patients underwent distal pancreatectomies for pancreatic body or tail cancer. Among them, this study specifically examined 88 patients with resectable pancreatic body or tail cancer to elucidate prognostic factors using a multivariable Cox proportional analysis. The Kaplan–Meier method evaluated the impact of SpV involvement in terms of both radiological and pathological aspects and the efficacy of neoadjuvant therapy.

Results

Higher pre-operative carcinoembryonic antigen levels, larger tumour size, pathological SpV invasion, and non-completion of adjuvant therapy were identified as independent poor prognostic factors for overall survival (OS) and recurrence-free survival (RFS). Additionally, patients with radiological SpV encasement had significantly worse prognoses in terms of OS (p = 0.039) and RFS (p < 0.001). The sensitivity and specificity of multidetector-row computed tomography for detecting pathological SpV invasion were 81.0% and 61.2%, respectively. However, the prognostic impact of neoadjuvant therapy could not be determined, regardless of radiological SpV involvement.

Conclusion

Radiological and pathological SpV involvement is a poor prognostic factor for patients with resectable pancreatic body or tail cancer. New innovative treatments and effective neoadjuvant therapy regimens are required for patients with SpV involvement.

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Title: Impact of radiological and pathological splenic vein involvement in patients with resectable pancreatic body or tail cancer
Authors: Naohisa Kuriyama
Shugo Mizuno
Tatsuya Sakamoto
Yu Fujimura
Takuya Yuge
Daisuke Noguchi
Takahiro Ito
Aoi Hayasaki
Takehiro Fujii
Yusuke Iizawa
Yasuhiro Murata
Akihiro Tanemura
Motonori Nagata
Miki Usui
Masashi Kishiwada
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 1/2024
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-024-03232-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of radiological and pathological splenic vein involvement in patients with resectable pancreatic body or tail cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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