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Splenic Artery Invasion in Pancreatic Adenocarcinoma of the Body and Tail: A Novel Prognostic Parameter for Patient Selection

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The value of splenic vessels invasion (which identified T3 tumors) in prognosis after resection for pancreatic ductal adenocarcinoma (PDA) of the body and tail has not been extensively investigated. The goal of this study was to evaluate prognostic factors in PDA of the body/tail, emphasizing the role of splenic vessels infiltration.

Methods

Between 1990 and 2008, 87 patients who underwent distal pancreatectomy (DP) for histologically proven PDA of the body and tail were analyzed. Clinicopathological prognostic factors for survival were evaluated. Univariate and multivariable analyses were performed.

Results

Postoperative morbidity was 31% with no mortality. The 1-, 3-, and 5-year overall survival rates were 77%, 48%, and 24.5%, respectively. Invasion of the splenic artery (SA) was observed in 19 patients (22%). Patients with SA invasion had a significantly poorer prognosis compared with those without SA invasion (median survival: 15 vs. 39 months, P = 0.014). On multivariable analysis, adjuvant therapy, poor differentiation (G3/G4), R2 resection, the presence of lymph node metastases, and SA invasion were independent predictors of survival.

Conclusions

Along with other well-known prognostic factors, invasion of SA is an independent predictor of poor survival in PDA of the body/tail. In case of the presence of SA infiltration, neoadjuvant treatment should be considered. SA infiltration might be reclassified from a T3 to T4 tumor.

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Acknowledgment

The authors thank Ms. Deborah McGrath for help with revising the manuscript.

Conflicts of interest

There are no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, University of Verona, Verona, Italy

    Stefano Partelli MD, Stefano Crippa MD, Giuliano Barugola MD, Domenico Tamburrino MD, Paolo Pederzoli MD & Massimo Falconi MD

  2. Department of Surgery, Ospedale “Sacro Cuore-Don Calabria,” Negrar, Verona, Italy

    Stefano Partelli MD, Stefano Crippa MD & Giuliano Barugola MD

  3. Department of Pathology, University of Verona, Verona, Italy

    Paola Capelli MD

  4. Department of Radiology, University of Verona, Verona, Italy

    Mirko D’Onofrio MD

Authors
  1. Stefano Partelli MD
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  2. Stefano Crippa MD
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  3. Giuliano Barugola MD
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  4. Domenico Tamburrino MD
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  5. Paola Capelli MD
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  6. Mirko D’Onofrio MD
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  7. Paolo Pederzoli MD
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  8. Massimo Falconi MD
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Corresponding author

Correspondence to Massimo Falconi MD.

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Partelli, S., Crippa, S., Barugola, G. et al. Splenic Artery Invasion in Pancreatic Adenocarcinoma of the Body and Tail: A Novel Prognostic Parameter for Patient Selection. Ann Surg Oncol 18, 3608–3614 (2011). https://doi.org/10.1245/s10434-011-1769-1

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  • DOI: https://doi.org/10.1245/s10434-011-1769-1

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