Detailed Abstract
[BP Poster Presentation 3]
[BP PP 3-2] Clinical relevance between survival outcomes and invasion of splenic vessels in pancreatic body or tail adenocarcinoma
Jae Seung KANG, Yoo Jin CHOI, Yoonhyeong BYUN, Youngmin HAN, Hongbeom KIM, Wooil KWON, Jin-Young JANG*
Surgery and Cancer Research Institute, Seoul National University College of Medicine, Korea
Introduction : Little was known about clinical impact of splenic vessels (SPVs) invasion of pancreatic body or tail adenocarcinoma in terms of survival outcomes. This study was to compare the survival outcomes between pancreatic adenocarcinomas (PDACs) with invasion of SPVs and those with no invasion, and to investigate the prognostic factors associated with adverse outcomes.
Methods : Between 2005 and 2018, patients who underwent distal pancreatectomy (DP) (except for DP-celiac axis resection) were enrolled. Patients who underwent neoadjuvant chemotherapy were excluded. Degree of invasion of SPVs was categorized with three groups (Group 1, no invasion; Group 2, 0 – 180 degree; Group 3, ≥180 degree) and formation of collateral vessels was investigated in preoperative computed tomography. Clinical variables, postoperative surgical outcomes, and survival outcomes were evaluated. Multivariate Cox-proportional analysis was performed for evaluating the prognostic factors.
Results : Total 249 patients were included. Operation time was longer (185 vs. 159 min, P=0.001) and intraoperative blood loss (415 vs. 278 mL, P=0.003) was higher in SPV invasion patients. Tumor size was larger (3.9 vs. 2.9cm, P=0.001) in SPV invasion patients, but the number of metastatic lymph nodes were comparable (1.7 vs. 1.4, P=0.241). 5-year overall survival rate was significantly different among three groups (Group 1, 38.4%; Group 2, 16.8%; Group 3, 9.7%, P<0.001). In the Cox-proportional analysis, adjuvant treatment, R0 resection, SPV invasion, and collateral formation were independent prognostic factors in survival outcome.
Conclusions : SPV invasion was associated with adverse survival outcomes in PDAC. Different approach such as neoadjuvant treatment would be needed in patients with SPV invasion.
Methods : Between 2005 and 2018, patients who underwent distal pancreatectomy (DP) (except for DP-celiac axis resection) were enrolled. Patients who underwent neoadjuvant chemotherapy were excluded. Degree of invasion of SPVs was categorized with three groups (Group 1, no invasion; Group 2, 0 – 180 degree; Group 3, ≥180 degree) and formation of collateral vessels was investigated in preoperative computed tomography. Clinical variables, postoperative surgical outcomes, and survival outcomes were evaluated. Multivariate Cox-proportional analysis was performed for evaluating the prognostic factors.
Results : Total 249 patients were included. Operation time was longer (185 vs. 159 min, P=0.001) and intraoperative blood loss (415 vs. 278 mL, P=0.003) was higher in SPV invasion patients. Tumor size was larger (3.9 vs. 2.9cm, P=0.001) in SPV invasion patients, but the number of metastatic lymph nodes were comparable (1.7 vs. 1.4, P=0.241). 5-year overall survival rate was significantly different among three groups (Group 1, 38.4%; Group 2, 16.8%; Group 3, 9.7%, P<0.001). In the Cox-proportional analysis, adjuvant treatment, R0 resection, SPV invasion, and collateral formation were independent prognostic factors in survival outcome.
Conclusions : SPV invasion was associated with adverse survival outcomes in PDAC. Different approach such as neoadjuvant treatment would be needed in patients with SPV invasion.
SESSION
BP Poster Presentation 3
E-Session 7/27 ~ 7/29 ALL DAY