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Splenic-vasculature involvement is associated with poor prognosis in resected distal pancreatic cancer

Gastroenterology Report 2021年第2期9卷 139-145,I0002页

作者： Feng Yin Mohammed Saad Jingmei Lin Christopher R.Jackson Bing Ren cynthia lawson Dipti M.Karamchandani Belen Quereda Bernabeu Wei Jiang Teena Dhir Richard Zheng Christopher W.Schultz Dongwei Zhang Courtney L.Thomas Xuchen Zhang Jinping Lai Michael Schild Xuefeng Zhang Hao Xie Xiuli Liu Department of Pathology and Anatomical Sciences University of MissouriColumbiaMOUSA Department of Pathology Indiana UniversityIndianapolisINUSA Department of Pathology Dartmouth-Hitchcock Medical CenterLebanonNHUSA Department of Pathology Pennsylvania State Health Milton S.Hershey Medical CenterHersheyPAUSA Department of Pathology Thomas Jefferson University HospitalPhiladelphiaPAUSA Department of Pathology and Laboratory Medicine University of Rochester Medical CenterRochesterNYUSA Department of Pathology Yale UniversityNew HavenCTUSA Department of Pathology and Laboratory Medicine Kaiser Permanente Sacramento Medical CenterSacramentoCAUSA Department of Pathology Duke UniversityDurhamNCUSA Department of Pathology Cleveland ClinicClevelandOHUSA Department of Gastrointestinal Oncology Moffitt Cancer CenterTampaFLUSA Department of Pathology Immunology and Lab MedicineUniversity of FloridaGainesvilleFLUSA

Background Distal pancreatic carcinoma is one of the most lethal cancers largely due to its high incidence of distant *** study aims to assess the prognostic value of splenic-vasculature involvement in resected distal pancreatic *** 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 *** 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 P<0.05).Multivariate analysis confirmed non-IPMN-associated adenocarcinoma,stage pT3,stage pN1-2,and postoperative 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 *** 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.

关键词： pancreatic cancer splenic artery splenic vein prognosis intraductal papillary mucinous neoplasm

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Validation of American Joint Committee on Cancer 8th edition of TNM staging in resected distal pancreatic cancer

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第2期11卷 25-39页

作者： Feng Yin Mohammed Saad Hao Xie Jingmei Lin Christopher R Jackson Bing Ren cynthia lawson Dipti M Karamchandani Belen Quereda Bernabeu Wei Jiang Teena Dhir Richard Zheng Christopher W Schultz Dongwei Zhang Courtney L Thomas Xuchen Zhang Jinping Lai Michael Schild Xuefeng Zhang Xiuli Liu Department of Pathology and Anatomical Sciences University of MissouriColumbiaMO 65212United States Department of Pathology Indiana UniversityIndianapolisIN 46202United States Division of Medical Oncology Mayo ClinicRochesterMN 55905United States Department of Pathology Dartmouth-Hitchcock Medical CenterLebanonPA 03766United States Department of Pathology Pennsylvania State Health Milton S.Hershey Medical CenterHersheyPA 17033United States Department of Pathology Thomas Jefferson University HospitalPhiladelphiaPA 19107United States Department of Pathology and Lab Medicine University of Rochester Medical CenterRochesterNY 14642United States Department of Pathology Yale UniversityNew HavenCT 06510United States Department of Pathology and Laboratory Medicine Kaiser Permanente Sacramento Medical CenterSacramentoCA 95825United States Department of Pathology Duke UniversityDurhamNC 27710United States Department of Pathology Cleveland ClinicClevelandOH 44195United States Department of Pathology Immunology and Lab MedicineUniversity of FloridaGainesvilleFL 32610United States

BACKGROUND In order to improve risk stratification and clinical management of the pancreatic ductal adenocarcinoma(PDAC),the American Joint Committee on Cancer(AJCC)has published its eighth edition staging *** major changes have been introduced in the new staging system for both T and N *** the rarity of resectable disease,distal pancreatic cancer is likely underrepresented in the published clinical studies,and how the impact of the staging system actually reflects on to clinical outcomes remain *** To validate the AJCC 8th edition of TNM staging in distal *** A retrospective cohort study was performed in seven academic medical centers in the United *** prognostic factors associated with progression-free survival(PFS)and overall survival(OS)were evaluated through univariate and multivariate *** Overall,454 patients were enrolled in the study,and were divided into 2 subgroups:Invasive intraductal papillary mucinous neoplasms(IPMN)(115 cases)and non-IPMN associated adenocarcinoma(339 cases).Compared to invasive IPMN,non-IPMN associated adenocarcinomas are more common in relatively younger patients,have larger tumor size,are more likely to have positive lymph nodes,and are associated with a higher tumor(T)stage and nodal(N)stage,lymphovascular invasion,perineural invasion,tumor recurrence,and a worse PFS and *** cohort was predominantly categorized as stage 3 per AJCC 7th edition staging manual,and it’s more evenly distributed based on 8th edition staging manual.T and N staging of both 7th and 8th edition sufficiently stratify PFS and OS in the entire cohort,although dividing into N1 and N2 according to the 8th edition does not show additional *** PDAC arising in IPMN,T staging of the 7th edition and N1/N2 staging of the 8th edition appear to further stratify PFS and *** PDAC without an IPMN component,T staging from both versions fails to stratify PFS and *** The AJ

关键词： Pancreatic cancer Pancreatic ductal adenocarcinoma Prognosis Intraductal papillary mucinous neoplasms Survival American Joint Committee on Cancer

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