Verification of Resectability Status for Pancreatic Cancer: Radiological and Pathological Analysis of Patients Undergoing Pancreatoduodenectomy With Combined Resection of the Superior Mesenteric Artery.
Journal
Pancreas
ISSN: 1536-4828
Titre abrégé: Pancreas
Pays: United States
ID NLM: 8608542
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
entrez:
23
2
2022
pubmed:
24
2
2022
medline:
22
3
2022
Statut:
ppublish
Résumé
Resectability status is considered an important indicator for progression of pancreatic cancer. We verified the superior mesenteric artery (SMA) factors of resectability status by radiological and pathological analysis in patients who underwent pancreatoduodenectomy with combined resection of the SMA. We enrolled 22 patients who underwent pancreatoduodenectomy with combined resection of the SMA. Patients were divided into 3 groups according to the contact angle between the tumor and the SMA in preoperative computed tomography images (no contact, R-sma; contact within 180 degrees, BR-sma; contact more than 180 degrees, UR-sma). We pathologically evaluated cancer progression toward the SMA. There were 3 patients with R-sma, 12 with BR-sma, and 7 with UR-sma. The median distance (mm) between the cancer and the SMA was 7.0 with R-sma, 1.0 with BR-sma, and 0 with UR-sma (P = 0.0003). Invasion to the superior mesenteric nerve plexus was positive in none with R-sma, 11 with BR-sma, and 7 with UR-sma (P < 0.0001). Invasion to the SMA was positive in none with R-sma and BR-sma, and 7 with UR-sma (P < 0.0001). Superior mesenteric artery factors of resectability status are reliable indicator for cancer progression toward the SMA.
Identifiants
pubmed: 35195593
doi: 10.1097/MPA.0000000000001964
pii: 00006676-202201000-00006
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-40Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Tempero MA, Malafa MP, Chiorean EG, et al. Pancreatic adenocarcinoma, version 1.2019. J Natl Compr Canc Netw . 2019;17:203–210.
Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw . 2017;15:1028–1061.
Murakami Y, Satoi S, Sho M, et al. National Comprehensive Cancer Network resectability status for pancreatic carcinoma predicts overall survival. World J Surg . 2015;39:2306–2314.
Noto M, Miwa K, Kitagawa H, et al. Pancreas head carcinoma: frequency of invasion to soft tissue adherent to the superior mesenteric artery. Am J Surg Pathol . 2005;29:1056–1061.
Kitagawa H, Tajima H, Nakagawara H, et al. En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma. Mol Clin Oncol . 2014;2:369–374.
Makino I, Kitagawa H, Ohta T, et al. Nerve plexus invasion in pancreatic cancer: spread patterns on histopathologic and embryological analyses. Pancreas . 2008;37:358–365.
Japan Pancreas Society. Classification of Pancreatic Carcinoma . Fourth English ed. Tokyo, Japan: Kanehara; 2017.
Sohal DPS, Kennedy EB, Khorana A, et al. Metastatic pancreatic cancer: ASCO clinical practice guideline update. J Clin Oncol . 2018;36:2545–2556.
Balaban EP, Mangu PB, Khorana AA, et al. Locally advanced, unresectable pancreatic cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol . 2016;34:2654–2667.
Wagner M, Antunes C, Pietrasz D, et al. CT evaluation after neoadjuvant FOLFIRINOX chemotherapy for borderline and locally advanced pancreatic adenocarcinoma. Eur Radiol . 2017;27:3104–3116.
Einama T, Kamachi H, Tsuruga Y, et al. Optimal resection area for superior mesenteric artery nerve plexuses after neoadjuvant chemoradiotherapy for locally advanced pancreatic carcinoma. Medicine (Baltimore) . 2018;97:e11309.
Nagakawa Y, Hosokawa Y, Osakabe H, et al. Pancreaticoduodenectomy with right-oblique posterior dissection of superior mesenteric nerve plexus is logical procedure for pancreatic cancer with extrapancreatic nerve plexus invasion. Hepatogastroenterology . 2014;61:2371–2376.
Jang JY, Kang MJ, Heo JS, et al. A prospective randomized controlled study comparing outcomes of standard resection and extended resection, including dissection of the nerve plexus and various lymph nodes, in patients with pancreatic head cancer. Ann Surg . 2014;259:656–664.
Hank T, Strobel O. Conversion surgery for advanced pancreatic cancer. J Clin Med . 2019;8:1945.
Furuse J, Shibahara J, Sugiyama M. Development of chemotherapy and significance of conversion surgery after chemotherapy in unresectable pancreatic cancer. J Hepatobiliary Pancreat Sci . 2018;25:261–268.
Klaiber U, Hackert T. Conversion surgery for pancreatic cancer—the impact of neoadjuvant treatment. Front Oncol . 2020;9:1501.