Radiographic Splenic Artery Involvement Is a Poor Prognostic Factor in Upfront Surgery for Patients with Resectable Pancreatic Body and Tail Cancer

• Published in: Annals of surgical oncology 2021-03, Vol.28 (3), p.1521-1532
• Main Authors: Kawai, Manabu, Hirono, Seiko, Okada, Ken-ichi, Miyazawa, Motoki, Kitahata, Yuji, Kobayashi, Ryohei, Ueno, Masaki, Hayami, Shinya, Yamaue, Hiroki
• Format: Article
• Language: English
• Subjects: Carcinoma, Pancreatic Ductal - surgery; Cytology; Humans; Medical prognosis; Medicine; Medicine & Public Health; Neoadjuvant Therapy; Oncology; Pancreatectomy; Pancreatic cancer; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - surgery; Pancreatic Tumors; Patients; Prognosis; Retrospective Studies; Spleen; Splenic artery; Splenic Artery - diagnostic imaging; Splenic Artery - surgery; Surgery; Surgical Oncology; Survival; Survival Rate; Tails; Veins & arteries
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-020-08922-8

Purpose The prognostic impact of radiographic splenic vessel involvement in pancreatic cancer remains unclear. We evaluate its oncological significance in resectable pancreatic body/tail cancer. Patients and Methods We retrospectively review 102 cases of resectable pancreatic cancer and 51 of borderline resectable pancreatic cancer (BRPC) who underwent pancreatectomy for pancreatic body/tail cancer. Resectable pancreatic body/tail cancer was classified into one of three categories based on radiographic splenic vessel involvement. Results Among 102 cases of resectable pancreatic cancer, 37 (36.3%), 35 (34.3%), and 30 cases (29.4%) were classified as no splenic vessel involvement (R none ), splenic vein involvement (RV), and splenic artery involvement (RA), respectively. Disease-free survival (DFS) among patients with R none , RV, RA, and BRPC was 58.5, 18.4, 10.8, and 9.2 months, respectively. Patients with RV and RA had significantly poorer DFS than patients with R none ( P  = 0.010, P