Significance of radiologic location and extent of portal venous involvement on prognosis after resection for pancreatic adenocarcinoma

Abstract

Objectives The aim of this study was to determine the prognosis of pancreatic adenocarcinoma patients with portal venous involvement according to its location and extent on radiologic findings. Methods From January 2003 to December 2011, the medical records of 543 patients who had undergone pancreaticoduodenectomy (PD) for pancreas head cancer in Asan Medical Center were retrospectively reviewed. The portal vein (PV) resection (PVR) patients (n = 147) were classified according to the location (NPVC group, without PV confluence invasion; PVC group, with PV confluence invasion) and extent (group A, the tumor surrounded less than two thirds of the vessel perimeter; group B, the tumor extended over two thirds) of venous involvement on radiologic findings. Results The survival rate of the patients who underwent PD with PVR was significantly lower than that of the patients who underwent PD without PVR (P = 0.009). The NPVC group and group A had significantly better prognoses than the PVC group and group B (P = 0.033 and P = 0.005, respectively). Conclusions Pancreatic cancer with venous involvement had different prognoses according to the location and extent of venous involvement. The patients with PV confluence or extensive vein invasion are recommended the neoadjuvant treatments.