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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 5/2014

01-06-2014 | Original Article

Outcome of superior mesenteric-portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospective comparative study

Authors: Federico Selvaggi, Giuseppe Mascetta, Despoina Daskalaki, Marco dal Molin, Roberto Salvia, Giovanni Butturini, Carlo Cellini, Claudio Bassi

Published in: Langenbeck's Archives of Surgery | Issue 5/2014

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Abstract

Background

Approximately 20 % of patients affected by pancreatic ductal adenocarcinoma are amenable to surgical resection. Several tumours are reported as “borderline resectable” because of their proximity to the major vessels. In the effort to achieve a radical tumour removal, vein resection has been proposed, but its oncological benefits remain debated.

Methods

Our aim is to investigate morbidity, mortality and survival after pancreatectomy with vein resection.

Results

Forty patients underwent pancreatectomy and vein resection (group A), and 20 patients (group B) underwent bilio-enteric and/or gastro-entero bypass. In group A, cancer vein invasion was microscopically proven in 14 cases (35 %). Vein infiltration, tumour differentiation and node-positive disease were not adverse prognostic variables. No difference in survival was seen over a 1-year follow-up. After this period, group A showed significant survival benefits with a longer stabilisation of the disease (p = 0.005). Tumour-free resection margins and adjuvant chemoradiotherapy were the most important prognostic factors (p < 0.05).

Conclusions

Suspicion of vein infiltration should not be a contraindication to resection. Pancreatectomy can be safely performed with an acceptable morbidity and better survival trend.
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Metadata
Title
Outcome of superior mesenteric-portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospective comparative study
Authors
Federico Selvaggi
Giuseppe Mascetta
Despoina Daskalaki
Marco dal Molin
Roberto Salvia
Giovanni Butturini
Carlo Cellini
Claudio Bassi
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 5/2014
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-014-1194-6

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