Scholarlink

Purpose <p>To investigate whether preoperative computed tomography (CT)-based tumor–portal/superior mesenteric vein (PV/SMV) contact angle and contact length predict pathological venous invasion and refine prognostic stratification in anatomically resectable pancreatic ductal adenocarcinoma (R-PDAC).</p> Methods <p>We retrospectively reviewed 108 patients who underwent upfront pancreaticoduodenectomy without neoadjuvant chemotherapy for pancreatic head PDAC, including 101 anatomically resectable cases and 7 borderline resectable cases with PV involvement (BR-PV). Tumor–PV/SMV contact angle and contact length were measured on multidetector CT. Their associations with pathological PV/SMV invasion, PV/SMV resection, and overall survival (OS) were analyzed.</p> Results <p>Both contact angle and contact length predicted pathological venous invasion, with optimal cutoff values of 90° for angle (AUC = 0.86) and 15&#xa0;mm for length (AUC = 0.84), and both were significantly associated with pathological venous invasion and PV/SMV resection (all <i>p</i> &lt; 0.001). In the subgroup with R-PDAC, however, only contact length provided meaningful prognostic stratification. Patients with contact length ≥ 15&#xa0;mm had significantly worse OS than those with contact length &lt; 15&#xa0;mm (<i>p =</i> 0.0032) or no contact (<i>p</i> &lt; 0.001), and their survival was comparable to that of BR-PV patients (<i>p =</i> 0.8548). In multivariable analysis, contact length ≥ 15&#xa0;mm remained an independent adverse prognostic factor (HR 2.79, 95% CI 1.64–4.73, <i>p</i> &lt; 0.001).</p> Conclusion <p>Preoperative CT-based assessment of tumor–PV/SMV contact length may serve as a practical marker for identifying a high-risk subgroup within R-PDAC and may help refine selection of patients for neoadjuvant treatment.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer

  • 期刊论文

  • 发表日期：

    2026年7月16日

查看全文
  • Shingo Kozono,
  • Takaaki Tatsuguchi,
  • Atsushi Fujii,
  • Hirotaka Kuga,
  • Keisuke Hirahata,
  • Yuzo Shimokawa,
  • Masayuki Hijioka,
  • Masato Sakamoto,
  • Sadafumi Tamiya,
  • Toru Nakano

摘要

Purpose

To investigate whether preoperative computed tomography (CT)-based tumor–portal/superior mesenteric vein (PV/SMV) contact angle and contact length predict pathological venous invasion and refine prognostic stratification in anatomically resectable pancreatic ductal adenocarcinoma (R-PDAC).

Methods

We retrospectively reviewed 108 patients who underwent upfront pancreaticoduodenectomy without neoadjuvant chemotherapy for pancreatic head PDAC, including 101 anatomically resectable cases and 7 borderline resectable cases with PV involvement (BR-PV). Tumor–PV/SMV contact angle and contact length were measured on multidetector CT. Their associations with pathological PV/SMV invasion, PV/SMV resection, and overall survival (OS) were analyzed.

Results

Both contact angle and contact length predicted pathological venous invasion, with optimal cutoff values of 90° for angle (AUC = 0.86) and 15 mm for length (AUC = 0.84), and both were significantly associated with pathological venous invasion and PV/SMV resection (all p < 0.001). In the subgroup with R-PDAC, however, only contact length provided meaningful prognostic stratification. Patients with contact length ≥ 15 mm had significantly worse OS than those with contact length < 15 mm (p = 0.0032) or no contact (p < 0.001), and their survival was comparable to that of BR-PV patients (p = 0.8548). In multivariable analysis, contact length ≥ 15 mm remained an independent adverse prognostic factor (HR 2.79, 95% CI 1.64–4.73, p < 0.001).

Conclusion

Preoperative CT-based assessment of tumor–PV/SMV contact length may serve as a practical marker for identifying a high-risk subgroup within R-PDAC and may help refine selection of patients for neoadjuvant treatment.