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Cited 15 time in webofscience Cited 16 time in scopus
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Significance of radiographic splenic vessel involvement in the pancreatic ductal adenocarcinoma of the body and tail of the gland

Authors
Hyun, Jong JinRose, J. BartAlseidi, Adnan A.Biehl, Thomas R.Helton, ScottCoy, David L.Kozarek, Richard A.Rocha, Flavio G.
Issue Date
Aug-2019
Publisher
John Wiley & Sons Inc.
Keywords
pancreatic adenocarcinoma; preoperative radiographic assessment; splenic vessel involvement
Citation
Journal of Surgical Oncology, v.120, no.2, pp 262 - 269
Pages
8
Indexed
SCI
SCIE
SCOPUS
Journal Title
Journal of Surgical Oncology
Volume
120
Number
2
Start Page
262
End Page
269
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1751
DOI
10.1002/jso.25498
ISSN
0022-4790
1096-9098
Abstract
Background and Objectives Unlike pancreatic head tumors, little is known about the biological significance of radiographic vessel involvement with pancreatic body/tail adenocarcinoma. We hypothesized radiographic splenic vessel involvement may be an adverse prognostic factor. Methods All distal pancreatectomies performed for resectable pancreatic adenocarcinoma between 2000 and 2016 were reviewed and clinicopatholgic data were collected, retrospectively. Preoperative computed tomography imaging was re-reviewed and splenic vessel involvement was graded as none, abutment, encasement, or occlusion. Results Among a total of 71 patients, splenic artery or vein encasement/occlusion was present in 41% (29 of 71) of patients, each. There were no significant differences in tumor size or grade, margin positivity, and perineural or lymphovascular invasion. However, splenic artery encasement/occlusion (P = 0.001) and splenic vein encasement/occlusion (P = 0.038) both correlated with lymph node positivity. Splenic artery encasement was associated with a reduced median overall survival (20 vs 30 months, P = 0.033). Multivariate analysis also showed that splenic artery encasement was an independent risk factor of worse survival (hazard ratio, 2.246; 95% confidence interval, 1.118-4.513; P = 0.023). Conclusion Patients with cancer of the body or tail of the pancreas presenting with radiographic encasement of the splenic artery, but not the splenic vein, have a poorer prognosis and perhaps should be considered for neoadjuvant therapy before an attempt at curative resection.
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Hyun, Jong Jin
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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