Yin Feng, Saad Mohammed, Lin Jingmei, Jackson Christopher R, Ren Bing, Lawson Cynthia, Karamchandani Dipti M, Bernabeu Belen Quereda, Jiang Wei, Dhir Teena, Zheng Richard, Schultz Christopher W, Zhang Dongwei, Thomas Courtney L, Zhang Xuchen, Lai Jinping, Schild Michael, Zhang Xuefeng, Xie Hao, Liu Xiuli
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, USA.
Department of Pathology, Indiana University, Indianapolis, IN, USA.
Gastroenterol Rep (Oxf). 2020 Nov 24;9(2):139-145. doi: 10.1093/gastro/goaa084. eCollection 2021 Apr.
Distal pancreatic carcinoma is one of the most lethal cancers largely due to its high incidence of distant metastasis. This study aims to assess the prognostic value of splenic-vasculature involvement in resected distal pancreatic carcinoma.
In this retrospective study, we collected the clinicopathologic information of 454 patients with pancreatic cancer and performed univariate and multivariate analyses to identify factors associated with progression-free survival (PFS) and overall survival (OS), with an emphasis on the prognostic value of splenic-artery and -vein involvement.
Univariate analysis revealed that larger tumor size, non-intraductal papillary mucinous neoplasm (non-IPMN)-associated adenocarcinoma, poor differentiation, stage pT3, nodal metastasis, lymphovascular invasion, perineural invasion, and pathologic and radiographic evidence of splenic-vein invasion were significantly associated with shorter PFS and OS (all < 0.05). Multivariate analysis confirmed non-IPMN-associated adenocarcinoma, stage pT3, stage pN1-2, and post-operative adjuvant chemotherapy as independent risk factors for both PFS and OS, and larger tumor size and radiographic evidence of splenic-artery invasion as predictors of PFS only.
Guidelines should be developed for a uniform approach with regard to the examination and reporting of the status of the splenic vasculature when dealing with distal-pancreatic-cancer specimens.
胰体尾癌是最致命的癌症之一，主要原因是其远处转移发生率高。本研究旨在评估脾血管受累对切除的胰体尾癌的预后价值。
在这项回顾性研究中，我们收集了454例胰腺癌患者的临床病理信息，并进行单因素和多因素分析，以确定与无进展生存期（PFS）和总生存期（OS）相关的因素，重点是脾动脉和脾静脉受累的预后价值。
单因素分析显示，肿瘤体积较大、非导管内乳头状黏液性肿瘤（非IPMN）相关腺癌、低分化、pT3期、淋巴结转移、脉管侵犯、神经周围侵犯以及脾静脉侵犯的病理和影像学证据与较短的PFS和OS显著相关（均P<0.05）。多因素分析证实，非IPMN相关腺癌、pT3期、pN1-2期和术后辅助化疗是PFS和OS的独立危险因素，而肿瘤体积较大和脾动脉侵犯的影像学证据仅是PFS的预测因素。
在处理胰体尾癌标本时，应制定指南，采用统一方法检查和报告脾血管状态。
