1. Borderline-resectable pancreatic adenocarcinoma: Contour irregularity of the venous confluence in pre-operative computed tomography predicts histopathological infiltration
- Author
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Kaissis, Georgios A., Lohöfer, Fabian K., Ziegelmayer, Sebastian, Danner, Julia, Jäger, Carsten, Schirren, Rebekka, Ankerst, Donna, Ceyhan, Güralp O., Friess, Helmut, Rummeny, Ernst J., Weichert, Wilko, and Braren, Rickmer F.
- Subjects
Clinical Oncology ,Male ,Adjuvant Chemotherapy ,Cardiovascular Procedures ,Science ,Cancer Treatment ,Surgical and Invasive Medical Procedures ,Vascular Surgery ,Sensitivity and Specificity ,Veins ,Pancreaticoduodenectomy ,Cancer Chemotherapy ,Drug Therapy ,Radiologists ,Medicine and Health Sciences ,Chemotherapy ,Humans ,Medical Personnel ,Portal Veins ,Retrospective Studies ,Surgical Resection ,Pharmaceutics ,Biology and Life Sciences ,Tumor Resection ,Pancreatic Neoplasms ,Professions ,Surgical Oncology ,Oncology ,People and Places ,Cardiovascular Anatomy ,Blood Vessels ,Medicine ,Population Groupings ,Female ,Anatomy ,Clinical Medicine ,Tomography, X-Ray Computed ,Research Article ,Carcinoma, Pancreatic Ductal - Abstract
PurposeThe purpose of the current study was to compare CT-signs of portal venous confluence infiltration for actual histopathological infiltration of the vein or the tumor/vein interface (TVI) in borderline resectable pancreatic ductal adenocarcinoma (PDAC).Methods and materials101 patients with therapy-naïve, primarily resected PDAC of the pancreatic head without arterial involvement were evaluated. The portal venous confluence was assessed for contour irregularity (defined as infiltration) and degree of contact. The sensitivity and specificity of contour irregularity versus tumor to vein contact >180° as well as the combination of the signs for tumor cell infiltration of the vessel wall or TVI was calculated. Overall survival (OS) was compared between groups.ResultsSensitivity and specificity of contour irregularity for identification of tumor infiltration of the portal venous confluence or the TVI was higher compared to tumor to vessel contact >180° for tumor cell infiltration (96%/79% vs. 91%/38% respectively, p180°/ both signs had significantly worse overall survival (16.2 vs. 26.5 months/ 17.9 vs. 37.4 months/ 18.5 vs. 26.5 months respectively, all pConclusionPortal venous confluence contour irregularity is a strong predictor of actual tumor cell infiltration of the vessel wall or the TVI and should be noted as such in radiological reports.
- Published
- 2019