| Title: |
Venous Resection During Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma-A Multicentre Propensity Score Matching Analysis of the Recurrence After Whipple’s (RAW) Study |
| Authors: |
Bellotti, Ruben; aroori, somaiah; Cardini, Benno; Ponholzer, Florian; Russell, Thomas; Labib, Peter; Pando, Elizabeth |
| Contributors: |
Institut Català de la Salut; Bellotti R, Cardini B, Ponholzer F Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria. Aroori S, Russell TB, Labib PL Department of HPB Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK. Pando E Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain; Vall d'Hebron Barcelona Hospital Campus |
| Source: |
Scientia |
| Publisher Information: |
MDPI |
| Publication Year: |
2025 |
| Subject Terms: |
Pàncrees - Càncer - Tractament; Pàncrees - Càncer - Cirurgia; Pàncrees - Càncer - Recaiguda; DISEASES::Neoplasms::Neoplasms::Neoplasms::Neoplasms by Site::Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Pancreatic Neoplasms::Carcinoma; Pancreatic Ductal; Other subheadings::Other subheadings::Other subheadings::/surgery; ANALYTICAL; DIAGNOSTIC AND THERAPEUTIC TECHNIQUES; AND EQUIPMENT::Surgical Procedures; Operative::Digestive System Surgical Procedures::Pancreaticoduodenectomy; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms; DISEASES::Neoplasms::Neoplastic Processes::Neoplasm Recurrence; Local; ENFERMEDADES::neoplasias::neoplasias::neoplasias::neoplasias por localización::neoplasias::neoplasias por localización::neoplasias de las glándulas endocrinas::neoplasias pancreáticas::carcinoma ductal pancreático; Otros calificadores::Otros calificadores::Otros calificadores::/cirugía; TÉCNICAS Y EQUIPOS ANALÍTICOS; DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::pancreatoduodenectomía; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas; ENFERMEDADES::neoplasias::procesos neoplásicos::recurrencia neoplásica local |
| Description: |
Neoadjuvant therapy; Pancreatic cancer; Pancreaticoduodenectomy ; Terapia neoadyuvante; Cáncer de páncreas; Pancreatoduodenectomía ; Teràpia neoadjuvant; Càncer de pàncrees; Pancreaticoduodenectomia ; Background: Pancreatoduodenectomy with venous resection (PDVR) may be performed to achieve tumour clearance in patients with a pancreatic ductal adenocarcinoma (PDAC) with venous involvement. This study aimed to evaluate the impact of PDVR on PDAC outcomes. Methods: In total, 435 PDAC patients with either R0 status (n = 322) or R1 status within the superior mesenteric vein groove (n = 113) were extracted from the Recurrence After Whipple’s (RAW) study dataset. PDVR patients were matched in a 1:2 ratio with standard PD patients. Comparisons were then made between the two groups (surgical radicality and survival). Results: A total of 81 PDVRs were matched with 162 PDs. Neoadjuvant chemotherapy (5.7% vs. 13.6%, p = 0.032) and R1 resection rates (17.9% vs. 42%, p < 0.001) were higher in the PDVR group. Risk factors for R1 resection included venous resection (p < 0.001 for sleeve and p = 0.034 for segmental resection), pT3 (p = 0.007), and pN1 stage (p = 0.045). PDVR patients had lower median overall survival (OS, 21 vs. 30 months (m), p = 0.023) and disease-free survival (DFS, 17 m vs. 24 m, p = 0.043). Among PDVR patients, R status did not impact on OS (R0: 23 m, R1: 21 m, p = 0.928) or DFS (R0: 18 m, R1: 17 m, p = 0.558). Irrespective of R status, systemic recurrence was higher in the PDVR group (p = 0.034). Conclusions: Independent of R status, the PDVR group had lower overall survival and higher systemic recurrence rates. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Cancers;17(7); https://doi.org/10.3390/cancers17071223; http://hdl.handle.net/11351/13148; 001464797700001 |
| DOI: |
10.3390/cancers17071223 |
| Availability: |
http://hdl.handle.net/11351/13148; https://doi.org/10.3390/cancers17071223 |
| Rights: |
Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.F4105FB6 |
| Database: |
BASE |