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Clin Radiol. 2018 Jun;73(6):564-573. doi: 10.1016/j.crad.2018.01.016. Epub 2018 Mar 6.

Prediction and clinical implications of portal vein/superior mesenteric vein invasion in patients with resected pancreatic head cancer: the significance of preoperative CT parameters.

Author information

1
Department of Radiology, Hanyang University College of Medicine, Hanyang University Seoul Hospital, Seoul, Republic of Korea.
2
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: kaienes.kang@samsung.com.
3
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
4
Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5
Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
6
Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea.

Abstract

AIM:

To determine the preoperative computed tomography (CT) parameters that predict portal vein/superior mesenteric vein (PV-SMV) invasion in patients with pancreatic head cancer, and to assess whether PV-SMV invasion affects patient survival.

MATERIALS AND METHODS:

Sixty patients with PV-SMV invasion, and 60 randomly selected patients without it, who had undergone preoperative CT and subsequent surgery for pancreatic head cancer were enrolled. The following CT parameters were evaluated using multivariate logistic regression and receiver operating characteristic analyses to predict vessel invasion (tumour size and margin, length of involved vessel, distance from the tumour to the vessel, vessel irregularity, the teardrop sign, and tumour-vein interface [TVI]). The Cox proportional hazard model was used to evaluate the effects of PV-SMV invasion on survival.

RESULTS:

In multivariate analysis, tumour size (odds ratio [OR]=1.99) and TVI (OR=3.79 [≤90°], 20.66 [>90°, ≤180°], and 47.24 [>180°]) were independent CT predictors of PV-SMV invasion (p<0.05); they achieved a sensitivity of 87%, a specificity of 75%, and an accuracy of 81%; however, PV-SMV invasion did not affect patient survival after surgery (p=0.374).

CONCLUSION:

In patients with pancreatic head cancer, preoperative CT parameters can predict PV-SMV invasion with high accuracy. PV-SMV invasion did not affect treatment outcome after surgery.

PMID:
29519500
DOI:
10.1016/j.crad.2018.01.016
[Indexed for MEDLINE]

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