Impact of resection margin status on survival after operation for pancreatic head cancer with extrapancreatic nerve plexus invasion
Background Extrapancreatic nerve plexus (PL) invasion of pancreatic ductal adenocarcinoma (PDAC) is an important factor for determining resectability and surgical method. We sought to clarify the characteristics of PDAC with PL invasion and clinical impact of the resection margin status on prognosis...
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| Veröffentlicht in: | Journal of surgical oncology 2022-11, Vol.126 (6), p.1038-1047 |
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| container_title | Journal of surgical oncology |
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| creator | Konishi, Takanori Takano, Shigetsugu Furukawa, Katsunori Takayashiki, Tsukasa Kuboki, Satoshi Suzuki, Daisuke Sakai, Nozomu Hosokawa, Isamu Mishima, Takashi Ohtsuka, Masayuki |
| description | Background
Extrapancreatic nerve plexus (PL) invasion of pancreatic ductal adenocarcinoma (PDAC) is an important factor for determining resectability and surgical method. We sought to clarify the characteristics of PDAC with PL invasion and clinical impact of the resection margin status on prognosis for PDAC with PL invasion.
Methods
A total of 242 patients with pancreatic head cancer who underwent pancreatectomy were evaluated. Clinicopathological data and patient survival were analyzed.
Results
Pathological PL invasion was observed in 68 patients (28.1%). Patients with PL invasion had significantly shorter disease‐free survival (DFS) and showed trends toward worse overall survival (OS) than those without PL invasion. While multivariate analysis revealed that PL invasion was not an independent prognostic factor, PL invasion was associated with extensive venous invasion and a high percentage of lymph node metastases, both of which were independent factors affecting DFS and OS. Among patients with PL invasion, there was no significant difference in DFS and OS between the R0 and R1 resection groups.
Conclusions
PL invasion is a common pathological feature of aggressive PDAC with high propensity for invasiveness and metastatic potential. The microscopic resection margin status may not affect the survival of pancreatic head cancer patients with PL invasion. |
| doi_str_mv | 10.1002/jso.27003 |
| format | Article |
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Extrapancreatic nerve plexus (PL) invasion of pancreatic ductal adenocarcinoma (PDAC) is an important factor for determining resectability and surgical method. We sought to clarify the characteristics of PDAC with PL invasion and clinical impact of the resection margin status on prognosis for PDAC with PL invasion.
Methods
A total of 242 patients with pancreatic head cancer who underwent pancreatectomy were evaluated. Clinicopathological data and patient survival were analyzed.
Results
Pathological PL invasion was observed in 68 patients (28.1%). Patients with PL invasion had significantly shorter disease‐free survival (DFS) and showed trends toward worse overall survival (OS) than those without PL invasion. While multivariate analysis revealed that PL invasion was not an independent prognostic factor, PL invasion was associated with extensive venous invasion and a high percentage of lymph node metastases, both of which were independent factors affecting DFS and OS. Among patients with PL invasion, there was no significant difference in DFS and OS between the R0 and R1 resection groups.
Conclusions
PL invasion is a common pathological feature of aggressive PDAC with high propensity for invasiveness and metastatic potential. The microscopic resection margin status may not affect the survival of pancreatic head cancer patients with PL invasion.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.27003</identifier><identifier>PMID: 35796724</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Carcinoma, Pancreatic Ductal - surgery ; Humans ; Margins of Excision ; Medical prognosis ; nerve plexus invasion ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms ; Pancreatic Neoplasms - pathology ; pancreaticoduodenectomy ; Pancreaticoduodenectomy - methods ; Prognosis ; resection margin status ; Retrospective Studies</subject><ispartof>Journal of surgical oncology, 2022-11, Vol.126 (6), p.1038-1047</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-fe3a97ddf3b53d0c852becc44679b74e41f26a8a971626dd682be210e35785283</citedby><cites>FETCH-LOGICAL-c3533-fe3a97ddf3b53d0c852becc44679b74e41f26a8a971626dd682be210e35785283</cites><orcidid>0000-0002-2169-1942 ; 0000-0002-6495-0422 ; 0000-0002-4403-8313 ; 0000-0002-4751-0652</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.27003$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.27003$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27926,27927,45576,45577</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35796724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Konishi, Takanori</creatorcontrib><creatorcontrib>Takano, Shigetsugu</creatorcontrib><creatorcontrib>Furukawa, Katsunori</creatorcontrib><creatorcontrib>Takayashiki, Tsukasa</creatorcontrib><creatorcontrib>Kuboki, Satoshi</creatorcontrib><creatorcontrib>Suzuki, Daisuke</creatorcontrib><creatorcontrib>Sakai, Nozomu</creatorcontrib><creatorcontrib>Hosokawa, Isamu</creatorcontrib><creatorcontrib>Mishima, Takashi</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki</creatorcontrib><title>Impact of resection margin status on survival after operation for pancreatic head cancer with extrapancreatic nerve plexus invasion</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Extrapancreatic nerve plexus (PL) invasion of pancreatic ductal adenocarcinoma (PDAC) is an important factor for determining resectability and surgical method. We sought to clarify the characteristics of PDAC with PL invasion and clinical impact of the resection margin status on prognosis for PDAC with PL invasion.
Methods
A total of 242 patients with pancreatic head cancer who underwent pancreatectomy were evaluated. Clinicopathological data and patient survival were analyzed.
Results
Pathological PL invasion was observed in 68 patients (28.1%). Patients with PL invasion had significantly shorter disease‐free survival (DFS) and showed trends toward worse overall survival (OS) than those without PL invasion. While multivariate analysis revealed that PL invasion was not an independent prognostic factor, PL invasion was associated with extensive venous invasion and a high percentage of lymph node metastases, both of which were independent factors affecting DFS and OS. Among patients with PL invasion, there was no significant difference in DFS and OS between the R0 and R1 resection groups.
Conclusions
PL invasion is a common pathological feature of aggressive PDAC with high propensity for invasiveness and metastatic potential. The microscopic resection margin status may not affect the survival of pancreatic head cancer patients with PL invasion.</description><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Humans</subject><subject>Margins of Excision</subject><subject>Medical prognosis</subject><subject>nerve plexus invasion</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>Prognosis</subject><subject>resection margin status</subject><subject>Retrospective Studies</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U1L7DAUBuAgis4dXdw_cAm48S6qadLmYynix4jgQl2HTHqqHTpNTdpR1_5xj47K5YKrcJKHlyQvIb9zdpgzxo8WKRxyxZjYIJOcGZkZZvQmmeAZzwpl2A75ldKCMWaMLLbJjiiVkYoXE_I6W_bODzTUNEICPzSho0sX75uOpsENY6K4kca4alaupa4eINLQQ3Qfsg6R9q7zEXD29AFcRT3OiJ6a4YHC8xDdP6CDuALat_CMwU23cglTdslW7doEe5_rlNydnd6eXGRX1-ezk-OrzItSiKwG4YyqqlrMS1Exr0s-B--LQiozVwUUec2l02hyyWVVSY3nPGeAr0WrxZQcrHP7GB5HSINdNslD27oOwpgsl1qy0ij9Tvf_o4swxg5vZ7niXHCtc4Pq71r5GFKKUNs-Nvh5LzZn9r0Zi83Yj2bQ_vlMHOdLqL7lVxUIjtbgqWnh5ecke3lzvY58AwPwmes</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Konishi, Takanori</creator><creator>Takano, Shigetsugu</creator><creator>Furukawa, Katsunori</creator><creator>Takayashiki, Tsukasa</creator><creator>Kuboki, Satoshi</creator><creator>Suzuki, Daisuke</creator><creator>Sakai, Nozomu</creator><creator>Hosokawa, Isamu</creator><creator>Mishima, Takashi</creator><creator>Ohtsuka, Masayuki</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2169-1942</orcidid><orcidid>https://orcid.org/0000-0002-6495-0422</orcidid><orcidid>https://orcid.org/0000-0002-4403-8313</orcidid><orcidid>https://orcid.org/0000-0002-4751-0652</orcidid></search><sort><creationdate>202211</creationdate><title>Impact of resection margin status on survival after operation for pancreatic head cancer with extrapancreatic nerve plexus invasion</title><author>Konishi, Takanori ; Takano, Shigetsugu ; Furukawa, Katsunori ; Takayashiki, Tsukasa ; Kuboki, Satoshi ; Suzuki, Daisuke ; Sakai, Nozomu ; Hosokawa, Isamu ; Mishima, Takashi ; Ohtsuka, Masayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-fe3a97ddf3b53d0c852becc44679b74e41f26a8a971626dd682be210e35785283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Humans</topic><topic>Margins of Excision</topic><topic>Medical prognosis</topic><topic>nerve plexus invasion</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - methods</topic><topic>Prognosis</topic><topic>resection margin status</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Konishi, Takanori</creatorcontrib><creatorcontrib>Takano, Shigetsugu</creatorcontrib><creatorcontrib>Furukawa, Katsunori</creatorcontrib><creatorcontrib>Takayashiki, Tsukasa</creatorcontrib><creatorcontrib>Kuboki, Satoshi</creatorcontrib><creatorcontrib>Suzuki, Daisuke</creatorcontrib><creatorcontrib>Sakai, Nozomu</creatorcontrib><creatorcontrib>Hosokawa, Isamu</creatorcontrib><creatorcontrib>Mishima, Takashi</creatorcontrib><creatorcontrib>Ohtsuka, Masayuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Konishi, Takanori</au><au>Takano, Shigetsugu</au><au>Furukawa, Katsunori</au><au>Takayashiki, Tsukasa</au><au>Kuboki, Satoshi</au><au>Suzuki, Daisuke</au><au>Sakai, Nozomu</au><au>Hosokawa, Isamu</au><au>Mishima, Takashi</au><au>Ohtsuka, Masayuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of resection margin status on survival after operation for pancreatic head cancer with extrapancreatic nerve plexus invasion</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2022-11</date><risdate>2022</risdate><volume>126</volume><issue>6</issue><spage>1038</spage><epage>1047</epage><pages>1038-1047</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Extrapancreatic nerve plexus (PL) invasion of pancreatic ductal adenocarcinoma (PDAC) is an important factor for determining resectability and surgical method. We sought to clarify the characteristics of PDAC with PL invasion and clinical impact of the resection margin status on prognosis for PDAC with PL invasion.
Methods
A total of 242 patients with pancreatic head cancer who underwent pancreatectomy were evaluated. Clinicopathological data and patient survival were analyzed.
Results
Pathological PL invasion was observed in 68 patients (28.1%). Patients with PL invasion had significantly shorter disease‐free survival (DFS) and showed trends toward worse overall survival (OS) than those without PL invasion. While multivariate analysis revealed that PL invasion was not an independent prognostic factor, PL invasion was associated with extensive venous invasion and a high percentage of lymph node metastases, both of which were independent factors affecting DFS and OS. Among patients with PL invasion, there was no significant difference in DFS and OS between the R0 and R1 resection groups.
Conclusions
PL invasion is a common pathological feature of aggressive PDAC with high propensity for invasiveness and metastatic potential. The microscopic resection margin status may not affect the survival of pancreatic head cancer patients with PL invasion.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35796724</pmid><doi>10.1002/jso.27003</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2169-1942</orcidid><orcidid>https://orcid.org/0000-0002-6495-0422</orcidid><orcidid>https://orcid.org/0000-0002-4403-8313</orcidid><orcidid>https://orcid.org/0000-0002-4751-0652</orcidid></addata></record> |
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| ispartof | Journal of surgical oncology, 2022-11, Vol.126 (6), p.1038-1047 |
| issn | 0022-4790 1096-9098 |
| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Carcinoma, Pancreatic Ductal - surgery Humans Margins of Excision Medical prognosis nerve plexus invasion Pancreatectomy Pancreatic cancer Pancreatic Neoplasms Pancreatic Neoplasms - pathology pancreaticoduodenectomy Pancreaticoduodenectomy - methods Prognosis resection margin status Retrospective Studies |
| title | Impact of resection margin status on survival after operation for pancreatic head cancer with extrapancreatic nerve plexus invasion |
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