TY - JOUR
T1 - Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients
T2 - A Nationwide Cohort Study
AU - Sillesen, Martin
AU - Hansen, Carsten Palnæs
AU - Dencker, Emilie Even
AU - Burgdorf, Stefan Kobbelgaard
AU - Krohn, Paul Suno
AU - Stender, Mogens Tornby
AU - Fristrup, Claus Wilki
AU - Storkholm, Jan Henrik
N1 - Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2022/12
Y1 - 2022/12
N2 - UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.
AB - UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.
U2 - 10.1097/AS9.0000000000000219
DO - 10.1097/AS9.0000000000000219
M3 - Journal article
C2 - 37600295
SN - 2691-3593
VL - 3
JO - Annals of surgery open
JF - Annals of surgery open
IS - 4
M1 - e219
ER -