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01-11-2020 | Computed Tomography | Original Article

Prognostic impact of abutment to the branches of the superior mesenteric artery in borderline resectable pancreatic cancer

Authors: Taisuke Imamura, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Katsuhisa Ohgi, Akiko Todaka, Akira Fukutomi, Rui Sato, Takeshi Aramaki, Katsuhiko Uesaka

Published in: Langenbeck's Archives of Surgery | Issue 7/2020

Abstract

Purpose

The clinical impact of abutment to an artery and its branch on resectability and prognosis in patients with borderline resectable pancreatic cancer is unclear.

Methods

Patients diagnosed with borderline resectable pancreatic cancer due to artery abutment between April 2012 and December 2018 were enrolled. Contact between arteries and the tumour was assessed by computed tomography (CT).

Results

A primary lesion was resected in 63 patients (R group) and unresected in 19 patients (UR group). Overall survival (OS) was worse in the UR group than in the R group (P < 0.001). Multivariate analysis showed that abutment to the superior mesenteric artery (SMA) branches (P = 0.001) was an independent predictor of poor OS after surgery. Regarding the initial recurrence pattern, abutment to the SMA branches was significantly associated with high incidence of distant metastasis (P < 0.001). According to the most distal SMA branch attached on CT, significant differences in RFS were found between absent–J1A (P = 0.017), J2A–J3A (P = 0.0313) and J3A–middle colic artery (MCA, P = 0.0476) but not between J1A–J2A (P = 0.8207). Significant prognostic differences in OS after initiation of the treatment were found between absent–J1A/J2A (P = 0.006) and J1A/J2A–J3A/MCA (P = 0.033) but not between J3A/MCA–UR (P = 0.494).

Conclusion

Abutment to the SMA branches was associated with high incidence of distant metastasis after resection and a poor survival. Especially, abutment to the J3A or MCA was associated with poor prognosis comparable with that of the UR group.

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Title: Prognostic impact of abutment to the branches of the superior mesenteric artery in borderline resectable pancreatic cancer
Authors: Taisuke Imamura
Yusuke Yamamoto
Teiichi Sugiura
Yukiyasu Okamura
Takaaki Ito
Ryo Ashida
Katsuhisa Ohgi
Akiko Todaka
Akira Fukutomi
Rui Sato
Takeshi Aramaki
Katsuhiko Uesaka
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Pancreatic Cancer
Pancreatic Cancer
Published in: Langenbeck's Archives of Surgery / Issue 7/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01970-4

At a glance: The STEP trials

Springer Medicine

Prognostic impact of abutment to the branches of the superior mesenteric artery in borderline resectable pancreatic cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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