Yin, FengSaad, MohammedLin, JingmeiJackson, Christopher R.Ren, BingLawson, CynthiaKaramchandani, Dipti M.Bernabeu, Belen QueredaJiang, WeiDhir, TeenaZheng, RichardSchultz, Christopher W.Zhang, DongweiThomas, Courtney L.Zhang, XuchenLai, JinpingSchild, MichaelZhang, XuefengXie, HaoLiu, Xiuli2024-03-212024-03-212020-11-24Yin F, Saad M, Lin J, et al. Splenic-vasculature involvement is associated with poor prognosis in resected distal pancreatic cancer. Gastroenterol Rep (Oxf). 2020;9(2):139-145. Published 2020 Nov 24. doi:10.1093/gastro/goaa084https://hdl.handle.net/1805/39382Background: Distal pancreatic carcinoma is one of the most lethal cancers largely due to its high incidence of distant metastasis. This study aims to assess the prognostic value of splenic-vasculature involvement in resected distal pancreatic carcinoma. Methods: 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 involvement. Results: 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 post-operative 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 only. Conclusion: 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.en-USAttribution 4.0 InternationalIntraductal papillary mucinous neoplasmPancreatic cancerPrognosisSplenic arterySplenic veinArticle