Is the Need for an Arterial Resection a Contraindication to Pancreatic Resection for Locally Advanced Pancreatic Adenocarcinoma? A Case-Matched Controlled Study

Background and Objectives: Arterial resection (AR) has traditionally been considered as a contraindication to pancreatic resection for locally advanced pancreatic adenocarcinoma. The objective was to evaluate if pancreatic resection with AR was worthwhile. Methods: Between January 1990 and December 2008 the records of 26 consecutive patients who underwent a curative-intent pancreatic resection for adenocarcinoma of the pancreas with AR (AR+group) were matched 1: 1 to those of the whole series of pancreatic resection performed in our institution. The final study population (n = 52) included two groups of patients: the study group AR+ = 26 and the control group ARS- = 26. Results: The 1-and 3-year survival rates were similar in the two groups (65.9% and 22.1%, median 17 months for the group AR +, versus 50.0% and 17.6%, median 12 months, for the group ARS-; P = 0.581). The multivariate analysis showed that: arterial wall invasion at the site of AR, the total number of resected lymph nodes of <= 15, and perineural invasion were independent prognostic factors for survival. Conclusion: Pancreatic resections with AR for adenocarcinoma allowed to obtain a 3-survival rate similar to that of a matched group of patients not requiring AR. J. Surg. Oncol 2011;103:75-84. (c) 2010 Wiley-Liss, Inc.