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Article Abstract
Background: Although portal vein (PV) contact ≤ 180° in pancreatic body/tail ductal adenocarcinoma (PbtCa) is a criterion for resectable, adequate evidence has not been established yet.
Methods: This retrospective study analyzed 1693 patients with PbtCa who underwent distal pancreatectomy across 31 institutions in Japan. Clinicopathological factors, survival, and recurrence pattern were compared among non-PV contact, PV contact, and celiac axis (CeA) contact groups.
Results: Overall survival (MST: 28.3 months) and the positive surgical margin rate (23%) in the PV contact (n = 168) were worse than those of non-PV contact (n = 1353, 47.9 months [p < 0.001], 13% [p = 0.001]), and were comparable with CeA contact (n = 172, 26.4 months [p = 0.136], 26% [p = 0.447]). Incidence of local recurrence (26%) and peritoneal recurrence (20%) in the PV contact were comparable to those in the CeA contact (21%, p = 0.309, and 19%, p = 0.915). Cox proportional hazards analysis revealed PV contact (hazard ratio, 1.295; p = 0.003) as independent prognostic factors for overall survival.
Conclusions: PbtCa with PV contact should be considered borderline resectable because of a high positive surgical margin rate and poor survival, similar to those in PbtCa with CeA contact.
Trial Registration: This study was registered in the UMIN Clinical Trial Registry (UMIN-CTR: UMIN000041642).
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