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Article

En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma

  • Authors:
    • Hirohisa Kitagawa
    • Hidehiro Tajima
    • Hisatoshi Nakagawara
    • Isamu  Makino
    • Tomoharu Miyashita
    • Masatoshi Shoji
    • Shinichi Nakanuma
    • Norihiro  Hayashi
    • Hiroyuki Takamura
    • Tetsuo Ohta
    • Hiroshi Ohtake
  • View Affiliations / Copyright

    Affiliations: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920‑8641, Japan, Department of Cardiovascular Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920‑8641, Japan
  • Pages: 369-374
    |
    Published online on: February 27, 2014
       https://doi.org/10.3892/mco.2014.266
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Abstract

Borderline resectable (BR) pancreatic head carcinoma (PhC) is an advanced disease, presenting with infiltration of major vessels. Major vascular resection (VR), particularly arterial resection, to achieve microscopic no residual tumor (R0) is a controversial approach, due to the potential complications. In this study, we aimed to clarify the benefit of en bloc R0 resection with VR for PhC by retrospectively evaluating 78 PhC patients who underwent pancreatoduodenectomy at our institute. The patients were divided into 4 groups as follows: R, resectable (n=20); BR‑V, BR involving the superior mesenteric vein or portal vein (PV) (n=28); BR‑SMA, BR involving the superior mesenteric artery (n=21); and BR‑HA, BR involving the hepatic artery (n=9). In total, 65 patients underwent VR, with 63, 21 and 9 patients undergoing PV, SMA and HA resection, respectively. The R0 rates were as follows: R group, 85%; BR‑V, 82%; BR‑SMA, 71%; and BR‑HA, 33%. The median survival time and 5‑year survival rate for R0 resection were 31 months and 25% in the R group, 22 months and 28% in the BR‑V group, 17 months and 27% in the BR‑SMA group and 10 months and 0% in the BR‑HA group, respectively. The prognosis was comparable among the BR‑V, BR‑SMA and R groups, but was significantly poorer in the BR‑HA group. In total, 5 patients (6.4%) died perioperatively (4 from postoperative hemorrhage and 1 from suffocation due to failure of expectoration, without pneumonia or asthma). Of the 4 patients who succumbed to hemorrhage, 3 had undergone arterial resection. Therefore, en bloc resection with major VR for R0 may be suitable for BR‑V and BR‑SMA PhC patients.
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Copy and paste a formatted citation
Spandidos Publications style
Kitagawa H, Tajima H, Nakagawara H, Makino I, Miyashita T, Shoji M, Nakanuma S, Hayashi N, Takamura H, Ohta T, Ohta T, et al: En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma. Mol Clin Oncol 2: 369-374, 2014.
APA
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M. ... Ohtake, H. (2014). En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma. Molecular and Clinical Oncology, 2, 369-374. https://doi.org/10.3892/mco.2014.266
MLA
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M., Nakanuma, S., Hayashi, N., Takamura, H., Ohta, T., Ohtake, H."En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma". Molecular and Clinical Oncology 2.3 (2014): 369-374.
Chicago
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M., Nakanuma, S., Hayashi, N., Takamura, H., Ohta, T., Ohtake, H."En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma". Molecular and Clinical Oncology 2, no. 3 (2014): 369-374. https://doi.org/10.3892/mco.2014.266
Copy and paste a formatted citation
x
Spandidos Publications style
Kitagawa H, Tajima H, Nakagawara H, Makino I, Miyashita T, Shoji M, Nakanuma S, Hayashi N, Takamura H, Ohta T, Ohta T, et al: En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma. Mol Clin Oncol 2: 369-374, 2014.
APA
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M. ... Ohtake, H. (2014). En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma. Molecular and Clinical Oncology, 2, 369-374. https://doi.org/10.3892/mco.2014.266
MLA
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M., Nakanuma, S., Hayashi, N., Takamura, H., Ohta, T., Ohtake, H."En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma". Molecular and Clinical Oncology 2.3 (2014): 369-374.
Chicago
Kitagawa, H., Tajima, H., Nakagawara, H., Makino, I., Miyashita, T., Shoji, M., Nakanuma, S., Hayashi, N., Takamura, H., Ohta, T., Ohtake, H."En bloc vascular resection for the treatment of borderline resectable pancreatic head carcinoma". Molecular and Clinical Oncology 2, no. 3 (2014): 369-374. https://doi.org/10.3892/mco.2014.266
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