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132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

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What are Prognostic Factors after Portal Venous Resection for Pancreatic Ductual Adenocarcioma?

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  • Hryhoryi Lapshyn - UKSH Campus Lübeck, Klinik für Chirurgie, Lübeck, Deutschland
  • Ulrich Friedrich Wellner - UKSH Campus Lübeck, Klinik für Chirurgie, Lübeck, Deutschland
  • Frank Makowiec - Uniklinik Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland
  • Ulrich Theodor Hopt - Uniklinik Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland
  • Tobias Keck - UKSH Campus Lübeck, Klinik für Chirurgie, Lübeck, Deutschland
  • Olivia Sick - Uniklinik Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland
  • Peter Bronsert - Uniklinik Freiburg, Institut für Pathologie, Freiburg, Deutschland
  • Uwe Wittel - Uniklinik Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland
  • Gabriel Seifert - Uniklinik Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch053

doi: 10.3205/15dgch053, urn:nbn:de:0183-15dgch0531

Published: April 24, 2015

© 2015 Lapshyn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Introduction: Portal venous resection (PVR) for pancreatic ductal adenocarcinoma (PDAC) is performed routinely in case of adhesion to the portal vein. Data on the oncologic impact of tumor characteristics on survival in this situation is limited. The aim was to identify prognostic factors after PVR for PDAC.

Material and methods: Retrospective analysis was performed on the basis of a prospectively maintained database and archived paraffin-embedded formalin fixed tissue slides stained by hematoxylin-eosin. Statistical analysis was performed with MedCalc software 14.8.1.

Results: From 2001 to 2012, n=86 cases with PVR for PDAC, long-term follow-up and sufficient tissue for re-assessment were identified. Histopathological re-review disclosed true cancerous portal vein wall invasion (PVI) in 39 resection specimen. Patients with and without PVI did not differ in baseline demographic and standard histopathological parameters except for a significant association of PVI with hemangiosis and positive margin status. Overall survival was 22 months. Only lymph node ratio and PVI were univariate and multivariately independent predictors of survival after resection. Without PVI, median survival was 11 months longer than with PVI (p=0.042).

Conclusion: If technically feasible, PVR should be performed routinely in case of PDAC adhesion to the portal vein. Survival in this situation is influenced by lymph node ratio and confirmed histopathologic invasion of the portal vein wall.

Figure 1 [Fig. 1]