Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Vascular Resection for Pancreas Cancer – 10-year Experience from a Single High Volume-center,” published in the October 2024 issue of Surgery by Henault et al.
Combined pancreatic and vascular resections are increasingly performed for pancreatic ductal adenocarcinoma (PDAC).
Researchers conducted a retrospective study to evaluate the outcomes of pancreatectomy with non-vascular resection (NVR), venous resection (VR), and arterial resection (AR).
They reviewed (2011–2023) 715 patients with PDAC who underwent curative-intent surgery, assessing associations among clinicopathological data, perioperative therapy, time to recurrence (TTR), and overall survival (OS).
The results showed 715 patients: 533 were resectable, 98 were borderline, and 84 were locally advanced. The most common procedure was pancreaticoduodenectomy (n=467); NVR was performed in 351 (58.2%), VR in 181 (30.0%), and AR in 70 (11.8%). Median TTR and OS were significantly shorter for VR (14.5 and 22.7 months) compared to NVR (18.6 and 30.5 months, P<0.001) and AR (20.6 and 30.9 months, P=0.004 and P=0.017). Chemotherapy or chemoradiation significantly prolonged TTR (20.1 vs. 10.2 months, P<0.001 and 25.3 vs. 16.4 months, P<0.001) and OS (31.5 vs. 17.2 months, P<0.001 and 35.5 vs. 27.5 months, P=0.030). The AR was associated with higher 90-day mortality rates, and in multivariable analysis, vascular resection was not associated with overall survival. Key predictors of longer TTR and OS included perioperative therapy, pathological N0 status, and absence of perineural invasion.
They concluded that pancreatectomy with AR was not linked to worse oncological outcomes but was associated with higher 90-day mortality rates, highlighting the importance of careful patient selection for AR in patients with PDAC.
