Tumoral Venous Invasion after Distal Pancreatectomy: A Risk Factor for Recurrence

Dig Surg. 2019;36(4):317-322. doi: 10.1159/000489276. Epub 2018 May 31.

Abstract

Background: Few data exist on postoperative outcomes of patients with pancreatic body-tail malignancies and tumoral venous invasion (VI). This study aimed at comparing survival and recurrence rate (RR) after distal pancreatectomy for adenocarcinoma in patients with and without tumoral VI.

Methods: All consecutive distal pancreatectomies (2000-2015) were collected. Demographics and peri- and postoperative data were recorded. Survivals were calculated using Kaplan-Meier curves.

Results: A total of 45 patients underwent distal pancreatectomies for malignancies, of which 33 patients had ductal adenocarcinomas and 2 had cystadenocarcinomas. Among these 35 adenocarcinomas, histological VI was found in 28 patients (80%). Characteristics and intraoperative data of patients with and without VI were similar. Complication rates were 15 of 28 (54%) in the VI group and 3 of 7 (43%) in the group without VI (p = 0.612). Five-year survival for the group with and without VI were 19 and 39% (p = 0.232), respectively. RR was 16 of 28 (57%) for the VI group and 1 of 7 (14%) for the group without VI (p = 0.042).

Conclusion: VI did not have an effect on postoperative -complications. Survivals were similar in case of VI or not. On the contrary, RR was higher in the VI group.

Keywords: Distal pancreatectomy; Pancreatic surgery; Vascular invasion.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery*
  • Aged
  • Carcinoma, Pancreatic Ductal / pathology*
  • Carcinoma, Pancreatic Ductal / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology*
  • Neoplasm Recurrence, Local
  • Pancreatectomy*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications
  • Prospective Studies
  • Risk Factors
  • Survival Rate
  • Veins / pathology*