Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study

Martin Sillesen; Carsten Palnæs Hansen; Emilie Even Dencker; Stefan Kobbelgaard Burgdorf; Paul Suno Krohn; Mogens Tornby Stender; Claus Wilki Fristrup; Jan Henrik Storkholm

doi:10.1097/AS9.0000000000000219

Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study

Martin Sillesen^*, Carsten Palnæs Hansen, Emilie Even Dencker, Stefan Kobbelgaard Burgdorf, Paul Suno Krohn, Mogens Tornby Stender, Claus Wilki Fristrup, Jan Henrik Storkholm

^*Corresponding author for this work

Abstract

UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.

BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.

METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).

RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).

CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.

Original language	English
Journal	Annals of surgery open : perspectives of surgical history, education, and clinical approaches
Volume	3
Issue number	4
Pages (from-to)	e219
ISSN	2691-3593
DOIs	https://doi.org/10.1097/AS9.0000000000000219
Publication status	Published - Dec 2022

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Sillesen, M., Hansen, C. P., Dencker, E. E., Burgdorf, S. K., Krohn, P. S., Stender, M. T., Fristrup, C. W., & Storkholm, J. H. (2022). Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study. Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 3(4), e219. https://doi.org/10.1097/AS9.0000000000000219

Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study. / Sillesen, Martin ; Hansen, Carsten Palnæs ; Dencker, Emilie Even et al.
In: Annals of surgery open : perspectives of surgical history, education, and clinical approaches, Vol. 3, No. 4, 12.2022, p. e219.

Research output: Contribution to journal › Journal article › Research › peer-review

Sillesen, M , Hansen, CP , Dencker, EE , Burgdorf, SK , Krohn, PS, Stender, MT, Fristrup, CW & Storkholm, JH 2022, 'Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study', Annals of surgery open : perspectives of surgical history, education, and clinical approaches, vol. 3, no. 4, pp. e219. https://doi.org/10.1097/AS9.0000000000000219

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title = "Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study",

abstract = "UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20\% vs 30\%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.",

author = "Martin Sillesen and Hansen, \{Carsten Paln{\ae}s\} and Dencker, \{Emilie Even\} and Burgdorf, \{Stefan Kobbelgaard\} and Krohn, \{Paul Suno\} and Stender, \{Mogens Tornby\} and Fristrup, \{Claus Wilki\} and Storkholm, \{Jan Henrik\}",

note = "Copyright {\textcopyright} 2022 The Author(s). Published by Wolters Kluwer Health, Inc.",

year = "2022",

month = dec,

doi = "10.1097/AS9.0000000000000219",

language = "English",

volume = "3",

pages = "e219",

journal = "Annals of surgery open : perspectives of surgical history, education, and clinical approaches",

issn = "2691-3593",

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TY - JOUR

T1 - Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients

T2 - A Nationwide Cohort Study

AU - Sillesen, Martin

AU - Hansen, Carsten Palnæs

AU - Dencker, Emilie Even

AU - Burgdorf, Stefan Kobbelgaard

AU - Krohn, Paul Suno

AU - Stender, Mogens Tornby

AU - Fristrup, Claus Wilki

AU - Storkholm, Jan Henrik

PY - 2022/12

Y1 - 2022/12

N2 - UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.

AB - UNLABELLED: To investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required.BACKGROUND: PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR-V). We hypothesized that PR+V results in lower OS compared with PR-V.METHOD: Retrospective study using data from the nationwide Danish Pancreatic Cancer Database from 2011 to 2020. Data on patients who underwent PR for PDAC were extracted. A group of PR patients found nonresectable on exploratory laparotomy (EXP) was also included. OS was assessed using Kaplan-Meier and Cox proportional hazards models adjusting for confounders (age, sex, R-resection level, chemotherapy, comorbidities, histology T and N classification, procedure subtype as well as tumor distance to the SMV/PV).RESULTS: Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR-V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR-V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408).CONCLUSION: When correcting for confounders, PR+V was not associated with lower OS compared with PR-V.

U2 - 10.1097/AS9.0000000000000219

DO - 10.1097/AS9.0000000000000219

M3 - Journal article

C2 - 37600295

SN - 2691-3593

VL - 3

SP - e219

JO - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

JF - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

IS - 4

ER -

Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients: A Nationwide Cohort Study

Abstract

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