Oncotarget

Research Papers:

Portal vein resection and reconstruction with artificial blood vessels is safe and feasible for pancreatic ductal adenocarcinoma patients with portal vein involvement: Chinese center experience

Zhi-Bo Xie, Ji-Chun Gu, Yi-Fan Zhang _, Lie Yao, Chen Jin, Yong-Jian Jiang, Ji Li, Feng Yang, Cai-Feng Zou and De-Liang Fu

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Oncotarget. 2017; 8:77883-77896. https://doi.org/10.18632/oncotarget.20847

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Abstract

Zhi-Bo Xie1,*, Ji-Chun Gu1,*, Yi-Fan Zhang2,*, Lie Yao1, Chen Jin1, Yong-Jian Jiang1, Ji Li1, Feng Yang1, Cai-Feng Zou1 and De-Liang Fu1

1Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China

2Department of Plastic & Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China

*These authors have contributed equally to this work

Correspondence to:

Yi-Fan Zhang, email: [email protected]

De-Liang Fu, email: [email protected]

Keywords: pancreatic ductal adenocarcinoma, portal vein involvement, pancreaticoduodenectomy, portal vein resection, artificial blood vessels

Received: June 13, 2017    Accepted: August 17, 2017    Published: September 12, 2017

ABSTRACT

Evidence shows that portal vein resection (PVR) increase the resectability but does little benefit to overall survival in all pancreatic ductal adenocarcinoma (PDAC) patients. But for patients with portal vein involvement, PVR is the only radical choice. But whether the PDAC patients with portal vein involvement would benefit from radical pancreaticoduodenectomy with PVR or not is controversial. All 204 PDAC patients with portal vein involvement were enrolled in this study [PVR group, n=106; surgical bypass (SB) group, n=52; chemotherapy group, n=46]. Overall survival and prognostic factors were analyzed among three groups. Moreover, a literature review of 13 studies were also conducted. Among 3 groups, patients in PVR group achieved a significant longer survival (median survival: PVR group, 22.83 months; SB group, 7.26 months; chemotherapy group, 10.64 months). Therapy choice [hazard ratio (HR) =1.593, 95% confidence interval (CI) 1.323 to 1.918, P<0.001], body mass index (HR=0.772, 95% CI 0.559 to 0.994, P=0.044) and carbohydrateantigen 19-9 (HR=1.325, 95% CI 1.064 to 1.651, P=0.012) were independent prognostic factors which significantly affected overall survival. Pancreaticoduodenectomy combined with PVR and reconstruct with artificial blood vessels is a safe and an appropriate therapy choice for resectable PDAC patients with portal vein involvement.


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