P-P13 Long-term outcome after portal vein resection during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matched analysis

• DOI: 10.1093/bjs/znab430.236
• Publication Date: 2021-12-16T22:03:16Z
• Authors: James Russell; Claire Stevens; Rahul Bhome; Dimitrios Karavias; Ali Arshad; Arjun Takhar; Thomas Armstrong; John Primrose; Brian Green; Zaed Hamady
• Keywords: Resection margin; Perineural invasion; Univariate analysis

Abstract Background Portal vein resection (PVR) with pancreaticoduodenectomy (PD) is often performed to achieve clear margins for patients vascular involvement in pancreatic ductal adenocarcinoma (PDAC). However, there evidence suggest that undergoing PVR have more advanced cancers, therefore the impact of on survival and recurrence remains unclear. The aim this study assess overall (OS) free (RFS) who underwent during PD, particular attention margin positivity. Methods A retrospective analysis was 638 PD a 12-year period. Exclusion criteria included non-PDAC tumours, neoadjuvant chemotherapy or intra-operative radiotherapy. 374 were (90 284 non-PVR). Patient characteristics histopathological factors associated OS RFS then evaluated using univariate multivariate Cox regression analyses. 270 180 non-PVR), matched by propensity score based perineural invasion, pT pN staging. Kaplan-Meier method used calculate log-rank tests. Results Resection positivity shorter (p < 0.0001), superior mesenteric (SMV) most significant risk factor competing risks analysis. Absent adjuvant chemotherapy, nodal metastasis independent higher blood loss = 0.009), but not increased length stay, complications readmissions. had staging, however, no difference 0.551) 0.256) between non-PVR after matching. Conclusions Positive are times, SMV prognostic indicator compared other margins. relatively safe procedure, it does intended benefits complete clearance. positivity, particularly margin, should be considered when making decisions regards treatments.