Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival
Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopatho...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Klein, Fritz [verfasserIn] Berresheim, Finja [verfasserIn] Felsenstein, Matthäus [verfasserIn] Malinka, Thomas [verfasserIn] Pelzer, Uwe [verfasserIn] Denecke, Timm [verfasserIn] Pratschke, Johann [verfasserIn] Bahra, Marcus [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: European journal of surgical oncology - Burlington, Mass. : Harcourt, 1995, 44 |
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| Übergeordnetes Werk: |
volume:44 |
| DOI / URN: |
10.1016/j.ejso.2018.05.002 |
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| Katalog-ID: |
ELV000678899 |
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| 245 | 1 | 0 | |a Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
| 264 | 1 | |c 2018 | |
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| 520 | |a Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. | ||
| 650 | 4 | |a Pancreatic adenocarcinoma | |
| 650 | 4 | |a Pancreatic resection | |
| 650 | 4 | |a Routine portal vein resection | |
| 650 | 4 | |a Surgical radicality | |
| 650 | 4 | |a True tumor infiltration | |
| 700 | 1 | |a Berresheim, Finja |e verfasserin |4 aut | |
| 700 | 1 | |a Felsenstein, Matthäus |e verfasserin |4 aut | |
| 700 | 1 | |a Malinka, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Pelzer, Uwe |e verfasserin |4 aut | |
| 700 | 1 | |a Denecke, Timm |e verfasserin |4 aut | |
| 700 | 1 | |a Pratschke, Johann |e verfasserin |4 aut | |
| 700 | 1 | |a Bahra, Marcus |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of surgical oncology |d Burlington, Mass. : Harcourt, 1995 |g 44 |h Online-Ressource |w (DE-627)320420361 |w (DE-600)2002481-2 |w (DE-576)103746862 |x 1532-2157 |7 nnns |
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| 936 | b | k | |a 44.81 |j Onkologie |
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2018 |
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2018 |
| allfields |
10.1016/j.ejso.2018.05.002 doi (DE-627)ELV000678899 (ELSEVIER)S0748-7983(18)31052-7 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Klein, Fritz verfasserin (orcid)0000-0002-8940-6001 aut Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration Berresheim, Finja verfasserin aut Felsenstein, Matthäus verfasserin aut Malinka, Thomas verfasserin aut Pelzer, Uwe verfasserin aut Denecke, Timm verfasserin aut Pratschke, Johann verfasserin aut Bahra, Marcus verfasserin aut Enthalten in European journal of surgical oncology Burlington, Mass. : Harcourt, 1995 44 Online-Ressource (DE-627)320420361 (DE-600)2002481-2 (DE-576)103746862 1532-2157 nnns volume:44 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 44 |
| spelling |
10.1016/j.ejso.2018.05.002 doi (DE-627)ELV000678899 (ELSEVIER)S0748-7983(18)31052-7 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Klein, Fritz verfasserin (orcid)0000-0002-8940-6001 aut Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration Berresheim, Finja verfasserin aut Felsenstein, Matthäus verfasserin aut Malinka, Thomas verfasserin aut Pelzer, Uwe verfasserin aut Denecke, Timm verfasserin aut Pratschke, Johann verfasserin aut Bahra, Marcus verfasserin aut Enthalten in European journal of surgical oncology Burlington, Mass. : Harcourt, 1995 44 Online-Ressource (DE-627)320420361 (DE-600)2002481-2 (DE-576)103746862 1532-2157 nnns volume:44 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 44 |
| allfields_unstemmed |
10.1016/j.ejso.2018.05.002 doi (DE-627)ELV000678899 (ELSEVIER)S0748-7983(18)31052-7 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Klein, Fritz verfasserin (orcid)0000-0002-8940-6001 aut Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration Berresheim, Finja verfasserin aut Felsenstein, Matthäus verfasserin aut Malinka, Thomas verfasserin aut Pelzer, Uwe verfasserin aut Denecke, Timm verfasserin aut Pratschke, Johann verfasserin aut Bahra, Marcus verfasserin aut Enthalten in European journal of surgical oncology Burlington, Mass. : Harcourt, 1995 44 Online-Ressource (DE-627)320420361 (DE-600)2002481-2 (DE-576)103746862 1532-2157 nnns volume:44 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 44 |
| allfieldsGer |
10.1016/j.ejso.2018.05.002 doi (DE-627)ELV000678899 (ELSEVIER)S0748-7983(18)31052-7 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Klein, Fritz verfasserin (orcid)0000-0002-8940-6001 aut Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration Berresheim, Finja verfasserin aut Felsenstein, Matthäus verfasserin aut Malinka, Thomas verfasserin aut Pelzer, Uwe verfasserin aut Denecke, Timm verfasserin aut Pratschke, Johann verfasserin aut Bahra, Marcus verfasserin aut Enthalten in European journal of surgical oncology Burlington, Mass. : Harcourt, 1995 44 Online-Ressource (DE-627)320420361 (DE-600)2002481-2 (DE-576)103746862 1532-2157 nnns volume:44 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 44 |
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10.1016/j.ejso.2018.05.002 doi (DE-627)ELV000678899 (ELSEVIER)S0748-7983(18)31052-7 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.65 bkl Klein, Fritz verfasserin (orcid)0000-0002-8940-6001 aut Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration Berresheim, Finja verfasserin aut Felsenstein, Matthäus verfasserin aut Malinka, Thomas verfasserin aut Pelzer, Uwe verfasserin aut Denecke, Timm verfasserin aut Pratschke, Johann verfasserin aut Bahra, Marcus verfasserin aut Enthalten in European journal of surgical oncology Burlington, Mass. : Harcourt, 1995 44 Online-Ressource (DE-627)320420361 (DE-600)2002481-2 (DE-576)103746862 1532-2157 nnns volume:44 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.65 Chirurgie AR 44 |
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Klein, Fritz @@aut@@ Berresheim, Finja @@aut@@ Felsenstein, Matthäus @@aut@@ Malinka, Thomas @@aut@@ Pelzer, Uwe @@aut@@ Denecke, Timm @@aut@@ Pratschke, Johann @@aut@@ Bahra, Marcus @@aut@@ |
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Klein, Fritz |
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Klein, Fritz ddc 610 bkl 44.81 bkl 44.65 misc Pancreatic adenocarcinoma misc Pancreatic resection misc Routine portal vein resection misc Surgical radicality misc True tumor infiltration Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
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610 DE-600 44.81 bkl 44.65 bkl Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival Pancreatic adenocarcinoma Pancreatic resection Routine portal vein resection Surgical radicality True tumor infiltration |
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ddc 610 bkl 44.81 bkl 44.65 misc Pancreatic adenocarcinoma misc Pancreatic resection misc Routine portal vein resection misc Surgical radicality misc True tumor infiltration |
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ddc 610 bkl 44.81 bkl 44.65 misc Pancreatic adenocarcinoma misc Pancreatic resection misc Routine portal vein resection misc Surgical radicality misc True tumor infiltration |
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Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
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Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
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Klein, Fritz Berresheim, Finja Felsenstein, Matthäus Malinka, Thomas Pelzer, Uwe Denecke, Timm Pratschke, Johann Bahra, Marcus |
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routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
| title_auth |
Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
| abstract |
Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. |
| abstractGer |
Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. |
| abstract_unstemmed |
Background: Extended pancreatic resections including resections of the portal (PV) may nowadays be performed safely. Limitations in distinguishing tumor involvement from inflammatory adhesions however lead to portal vein resections (PVR) without evidence of tumor infiltration in the final histopathological examination. The aim of this study was to analyze the impact of these “false negative” resections on operative outcome and long-term survival.Methods: 40 patients who underwent pancreatic resection with PVR for pancreatic adenocarcinoma (PA) without tumor infiltration of the PV (PVR-group) were identified. In a 1:3 match these patients were compared to 120 patients after standard pancreatic resection without PVR (SPR-group) with regard to operative outcome and overall survival.Results: Survival analysis revealed that median survival was significantly shorter in the PVR group (311 days) as compared to the SPR group (558 days), (p = 0.0011, hazard ratio 1.98, 95% CI: 1.31–2.98). Also postoperative complications ≥ Clavien III occurred significantly more often in the PVR group (37.5% vs. 20.8%).Conclusions: Radical resection affords the best chance for long-term survival in patients with PA. Based on the results of this study a routine resection of the PV as recently proposed may however not be recommended. |
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Routine portal vein resection for pancreatic adenocarcinoma shows no benefit in overall survival |
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Berresheim, Finja Felsenstein, Matthäus Malinka, Thomas Pelzer, Uwe Denecke, Timm Pratschke, Johann Bahra, Marcus |
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| score |
7.398863 |