Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2023
Prognostic impact of the distance from the root of splenic artery to tumor in the patients with pancreatic body or tail cancer.
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Minagawa Takuya, Okamura Yukiyasu, Sugiura Teiichi, Ito Takaaki, Yamamoto Yusuke, Ashida Ryo, Ohgi Katsuhisa, Sasaki Keiko, Uesaka Katsuhiko
Аннотация
BACKGROUND: The impact of the distance from the root of splenic artery to tumor (DST) on the prognosis and optimal surgical procedures in the patients with pancreatic body/tail cancer has been unclear.
METHODS: We retrospectively analyzed 94 patients who underwent distal pancreatectomy (DP) and 17 patients who underwent DP with celiac axis resection (DP-CAR) between 2008 and 2018.
RESULTS: The 111 patients were assigned by DST length (in mm) as DST = 0: n = 14, 0<DST≤10: n = 18, and 10<DST: n = 79. The median overall survival (OS) and relapse-free survival (RFS) did not significantly differ in each group. A multivariate analysis showed that DST was not an independent prognostic factor for both RFS and OS. DP-CAR did not improve the prognosis in the DST = 0 and the 0<DST≤10 groups. In the DST = 0 group, neoadjuvant therapy significantly decreased distant metastasis (P = 0.025) and improve the overall survival (P = 0.046).
CONCLUSIONS: DST did not affect prognosis in patients with pancreatic body/tail cancer. Neoadjuvant therapy followed by DP may be desirable for patients with a DST = 0 tumor. For those with a 0<DST≤10 tumor, DP may be suitable; DP-CAR is an alternative when ligation and dissection of the root of the splenic artery are difficult or not possible.
METHODS: We retrospectively analyzed 94 patients who underwent distal pancreatectomy (DP) and 17 patients who underwent DP with celiac axis resection (DP-CAR) between 2008 and 2018.
RESULTS: The 111 patients were assigned by DST length (in mm) as DST = 0: n = 14, 0<DST≤10: n = 18, and 10<DST: n = 79. The median overall survival (OS) and relapse-free survival (RFS) did not significantly differ in each group. A multivariate analysis showed that DST was not an independent prognostic factor for both RFS and OS. DP-CAR did not improve the prognosis in the DST = 0 and the 0<DST≤10 groups. In the DST = 0 group, neoadjuvant therapy significantly decreased distant metastasis (P = 0.025) and improve the overall survival (P = 0.046).
CONCLUSIONS: DST did not affect prognosis in patients with pancreatic body/tail cancer. Neoadjuvant therapy followed by DP may be desirable for patients with a DST = 0 tumor. For those with a 0<DST≤10 tumor, DP may be suitable; DP-CAR is an alternative when ligation and dissection of the root of the splenic artery are difficult or not possible.