Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients

Martin Sillesen, MD, PhD; Carsten Palnæs Hansen, MD, DMSC; Emilie Even Dencker, MD; Stefan Kobbelgaard Burgdorf, MD, PhD; Paul Suno Krohn, MD; Mogens Tornby Stender, MD, PhD; Claus Wilki Fristrup, MD, PhD; Jan Henrik Storkholm, MD, PhD

doi:10.1097/AS9.0000000000000219

Annals of Surgery Open (Dec 2022)

Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients

Martin Sillesen, MD, PhD,
Carsten Palnæs Hansen, MD, DMSC,
Emilie Even Dencker, MD,
Stefan Kobbelgaard Burgdorf, MD, PhD,
Paul Suno Krohn, MD,
Mogens Tornby Stender, MD, PhD,
Claus Wilki Fristrup, MD, PhD,
Jan Henrik Storkholm, MD, PhD

Affiliations

Martin Sillesen, MD, PhD: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark
Carsten Palnæs Hansen, MD, DMSC: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark
Emilie Even Dencker, MD: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark
Stefan Kobbelgaard Burgdorf, MD, PhD: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark
Paul Suno Krohn, MD: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark
Mogens Tornby Stender, MD, PhD: ‡ Department of Surgery, Aalborg University Hospital, Aalborg, Denmark
Claus Wilki Fristrup, MD, PhD: § Department of Surgery, Odense University Hospital, Odense, Denmark
Jan Henrik Storkholm, MD, PhD: From the * Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark

DOI: https://doi.org/10.1097/AS9.0000000000000219
Journal volume & issue: Vol. 3, no. 4
p. e219

Abstract

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Objective:. 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.

Published in Annals of Surgery Open

ISSN: 2691-3593 (Online)
Publisher: Wolters Kluwer Health
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://journals.lww.com/aosopen/pages/default.aspx

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