Mesopancreatic Stromal Clearance Defines Curative Resection of Pancreatic Head Cancer and Can Be Predicted Preoperatively by Radiologic Parameters

Wellner, Ulrich; Krauß, Tobias; Csanádi, Ágnes; Lapshyn, Hryhoriy; Bolm, Louisa; Timme, Sylvia; Kulemann, Birte; Hoeppner, Jens; Kuesters, Simon; Seifert, Gabriel; Bausch, Dirk; Schilling, Oliver; Vashist, Yogesh K.; Brückner, Thomas; Langer, M.; Makowiec, Frank; Hopt, Ulrich T.; Werner, Martin; Keck, Tobias; Bronsert, Peter

doi:10.1097/md.0000000000002529

Cited by 19 publications

(13 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kato et al found impaired overall survival rates and a higher rate of early distant metastasis in patients with a reticular pattern surrounding the SMA [19]. We recently demonstrated that perivascular SMA stranding is a preoperative radiological marker of fibrotic stroma resection (S+ status) at the mesopancreatic resection margin [20]. In this study, S+ status was a strong negative prognostic parameter and served as a surrogate of aggressive tumor biology and advanced tumor cell dissemination.…”

Section: Discussionsupporting

confidence: 55%

Systematic Analysis of Accuracy in Predicting Complete Oncological Resection in Pancreatic Cancer Patients—Proposal of a New Simplified Borderline Resectability Definition

Bolm

Mueller

May

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

Background: Borderline resectability in pancreatic cancer (PDAC) is currently debated. Methods: Patients undergoing pancreatic resections for PDAC were identified from a prospectively maintained database. As new borderline criteria, the presence of any superior mesenterico-portal vein alteration (SMPV) and perivascular stranding of the superior mesenteric artery (SMA) was evaluated in preoperative imaging. The accuracy of established radiological borderline criteria as compared to the new borderline criteria in predicting R status (sensitivity/negative predictive value) and overall survival was assessed. Results: 118 patients undergoing pancreatic resections for PDAC from 2013 to 2018 were identified. Forty-three (36.4%) had radiological perivascular SMA stranding and 55 (46.6%) had SMPV alterations. Interrater reliability was 90% for SMA stranding and 87% for SMPV alterations. The new borderline definition including SMPV alterations and perivascular SMA stranding was the best predictor of conventional R status (p = 0.040, sensitivity 53%, negative predictive value 81%) and Leeds/Wittekind circumferential margin status (p = 0.050, sensitivity 73%, negative predictive value 79%) as compared to established borderline resectability definition criteria. Perivascular SMA stranding qualified as an independent negative prognostic parameter (HR 3.066, 95% CI 1.078–5.716, p = 0.036). Conclusion: The radiological evaluation of any SMPV alteration and perivascular SMA stranding predicts R status and overall survival in PDAC patients, and may serve to identify potential candidates for neoadjuvant therapy.

show abstract

Section: Discussionsupporting

confidence: 55%

Systematic Analysis of Accuracy in Predicting Complete Oncological Resection in Pancreatic Cancer Patients—Proposal of a New Simplified Borderline Resectability Definition

Bolm

Mueller

May

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

“…The overall margin positive rate in patients with PVR from this study (29%) is similar to the overall margin positive rate in pancreatic head resections for PDAC at our institution of around 30%, 31 but margin positive resections were associated with PVI. The PVR segment margin was the single affected margin in only one case, while the mesopancreatic margin was simultaneously positive in all other cases with positive PVR margins (n = 5).…”

Section: Discussionsupporting

confidence: 82%

Histopathological tumor invasion of the mesenterico-portal vein is characterized by aggressive biology and stromal fibroblast activation

Lapshyn

Bolm

Kohler

et al. 2017

HPB

Self Cite

View full text Add to dashboard Cite

show abstract

“…For all specimens a standardized gross examination and histopathological work-up 26 was performed. Frozen section analysis, examined by experienced pathologists, was performed for all specimens at the Institute of Surgical Pathology, University Medical Center Freiburg, Germany.…”

Section: Methodsmentioning

confidence: 99%

Pregnancy Specific β-1 Glycoprotein 1 is Expressed in Pancreatic Ductal Adenocarcinoma and its Subcellular Localization Correlates with Overall Survival

et al. 2016

Self Cite

View full text Add to dashboard Cite

Proteins of the pregnancy specific β-1 glycoprotein (PSG) family are renowned for their elevated expression during pregnancy. Only few reports have investigated their expression in adenocarcinomas. We studied the expression of PSG1 in pancreatic adenocarcinoma (PDAC). In a cohort of 104 patient samples, immunohistochemical analysis determined PSG1 expression in every specimen. PSG1 was found at apical and cytoplasmic localization or solely at cytoplasmic localization, with the latter case being correlated to shortened median survival (25 vs 11 months, logrank p-value < 0.001). At the same time, enzyme linked immunosorbent assay (ELISA) did not detect elevated PSG1 levels in the plasma of PDAC patients as opposed to the plasma of healthy, non-pregnant control individuals. We also probed the impact of PSG1 expression in a murine tumor model system, using subcutaneous injection of Colo-26 cells into immunocompetent BALB/c mice. Here, tumor growth was not affected by the expression of human PSG1. Our study reaffirms interest into the tumor-contextual biology of PSG proteins.

show abstract

Mesopancreatic Stromal Clearance Defines Curative Resection of Pancreatic Head Cancer and Can Be Predicted Preoperatively by Radiologic Parameters

Abstract: Supplemental Digital Content is available in the text

Cited by 19 publications

References 41 publications

Systematic Analysis of Accuracy in Predicting Complete Oncological Resection in Pancreatic Cancer Patients—Proposal of a New Simplified Borderline Resectability Definition

Systematic Analysis of Accuracy in Predicting Complete Oncological Resection in Pancreatic Cancer Patients—Proposal of a New Simplified Borderline Resectability Definition

Histopathological tumor invasion of the mesenterico-portal vein is characterized by aggressive biology and stromal fibroblast activation

Pregnancy Specific β-1 Glycoprotein 1 is Expressed in Pancreatic Ductal Adenocarcinoma and its Subcellular Localization Correlates with Overall Survival

Contact Info

Product

Resources

About