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Annals of Surgical Oncology

, Volume 18, Issue 13, pp 3608–3614 | Cite as

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

  • Stefano Partelli
  • Stefano Crippa
  • Giuliano Barugola
  • Domenico Tamburrino
  • Paola Capelli
  • Mirko D’Onofrio
  • Paolo Pederzoli
  • Massimo Falconi
Pancreatic Tumors

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.

Keywords

Distal Pancreatectomy Splenic Artery Pancreatic Ductal Adenocarcinoma Splenic Vein Splenic Vessel 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

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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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Stefano Partelli
    • 1
    • 2
  • Stefano Crippa
    • 1
    • 2
  • Giuliano Barugola
    • 1
    • 2
  • Domenico Tamburrino
    • 1
  • Paola Capelli
    • 3
  • Mirko D’Onofrio
    • 4
  • Paolo Pederzoli
    • 1
  • Massimo Falconi
    • 1
  1. 1.Department of SurgeryUniversity of VeronaVeronaItaly
  2. 2.Department of SurgeryOspedale “Sacro Cuore-Don Calabria,” NegrarVeronaItaly
  3. 3.Department of PathologyUniversity of VeronaVeronaItaly
  4. 4.Department of RadiologyUniversity of VeronaVeronaItaly

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