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Clinical Outcomes of Preservation Versus Resection of Portal/Superior Mesenteric Vein During Pancreaticoduodenectomy in Pancreatic Cancer Patients Who Respond to Neoadjuvant Treatment

Completed
Conditions
Pancreatic Head Cancer Patients Who Underwent Surgery After Neoadjuvant Treatment
Interventions
Procedure: portal/superior vein resection
Registration Number
NCT06372886
Lead Sponsor
Seoul National University Hospital
Brief Summary

1. There is a lack of evidence on the need to perform portal/superior mesenteric vein (PV/SMV) resection routinely in pancreatic ductal adenocarcinoma (PDAC) patients with venous involvement who responded to neoadjuvant treatment (NAT).

2. There is no significant differences in R0 rate, 5-year overall survival and recurrence-free survival between the PV/SMV preservation (PVP) group and PV/SMV resection (PVR) group.

3. PVP group showed significantly better 5-year PV/SMV stenosis free survival than the PVR group.

4. We propose that if dissection is possible and there is a high likelihood of achieving R0 resection after NAT, routine PVR may be unnecessary in PDAC patients with venous involvement.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
264
Inclusion Criteria
  • Pancreatic head cancer patients who underwent surgery after neoadjuvant treatment between January 2012 and December 2022 at Seoul National University Hospital
Exclusion Criteria
  • Metastatic unresectable and locally advanced pancreatic cancer
  • Resectable pancreatic cancer without portal/superior mesenteric vein invasion
  • Cancer aggravation after neoadjuvant treatment
  • Portal/superior mesenteric vein encasing and narrowing after neoadjuvant treatment
  • Patients who underwent palliative surgery
  • Non-pancreatic ductal adenocarcinoma patients
  • Patients who death within 30 days of surgery
  • Loss of follow-up patients
  • Patients who underwent resection for suspected main artery and adjacent organ invasion

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Preservation of portal/superior mesenteric veinportal/superior vein resection-
Resection of portal/superior mesenteric veinportal/superior vein resection-
Primary Outcome Measures
NameTimeMethod
5-year overall survivalassessed up to 60months

from diagnosis to any cause of death

5-year portal/superior mesenteric vein stenosis free survivalassessed up to 60months

from surgery to stenosis

Secondary Outcome Measures
NameTimeMethod
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