Oncotarget

Research Papers:

Histopathologic tumor invasion of superior mesenteric vein/ portal vein is a poor prognostic indicator in patients with pancreatic ductal adenocarcinoma: results from a systematic review and meta-analysis

Ailin Song, Farong Liu, Lupeng Wu, Xiaoying Si and Yanming Zhou _

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Oncotarget. 2017; 8:32600-32607. https://doi.org/10.18632/oncotarget.15938

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Abstract

Ailin Song1,*, Farong Liu2,*, Lupeng Wu2, Xiaoying Si2, Yanming Zhou2

1Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China

2Department of Hepatobiliary and Pancreatovascular Surgery, First affiliated Hospital of Xiamen University, Xiamen, China

*These authors contributed equally to this work

Correspondence to:

Yanming Zhou, email: [email protected]

Keywords: pancreatic adenocarcinoma, survival, prognosis, superior mesenteric vein, portal vein

Received: October 12, 2016     Accepted: February 22, 2017     Published: March 06, 2017

ABSTRACT

BACKGROUND: The impact of histopathologic tumor invasion of the superior mesenteric vein (SMV)/portal vein (PV) on prognosis in patients with pancreatic ductal adenocarcinoma (PDAC) after pancreatectomy remains controversial. A meta-analysis was performed to assess this issue.

RESULTS: Eighteen observational studies comprising 5242 patients were eligible, of whom 2199 (41.9%) patients received SMV/PV resection. Histopathologic tumor invasion was detected in 1218 (58.1%) of the 2096 resected SMV/PV specimens. SMV/PV invasion was associated with higher rates of poor tumor differentiation (P = 0.002), lymph node metastasis (P < 0.001), perineural invasion (P < 0.001), positive resection margins (P = 0.004), and postoperative tumor recurrence (P < 0.001). SMV/PV invasion showed a significantly negative effect on survival in total patients who underwent pancreatectomy with and without SMV/PV resection (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 1.08–1.35; P = 0.001) and in patients who underwent pancreatectomy with SMV/PV resection (HR: 1.88, 95% CI, 1.48–2.39; P < 0.001).

MATERIALS AND METHODS: A systematic literature search was performed to identify articles published from January 2000 to August 2016. Data were pooled for meta-analysis using Review Manager 5.3.

CONCLUSIONS: Histopathologic tumor invasion of the SMV/PV is associated with more aggressive biologic behavior and could be used as an indicator of poor prognosis after PDAC resection.


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