14. Pancreatic head adenocarcinoma: Role of msct prediction of resectablity according to nccn criteria
Main Article Content
Abstract
The study is intended to evaluate the diagnosis performance of multi-sequence computed tomography in determining resectability of pancreatic head adenocarcinoma, especially in resection margin status. Among the various imaging-based resectability criteria those proposed by the National Comprehensive Cancer Network (NCCN) are the most widely used and serve to classify pancreatic cancer as resectable, borderline resectable, or unresectable. We selected 105 patients who underwent an abdominal MSCT scan at the Vietnam-Germany Hospital from 1/2020 to 8/2022. Results: tumor size (< 4cm) were significantly associated with margin-negative resection with OR = 7.58 (95%CI: 3.12 – 18.42, p < 0.001). Invasion of arteries and veins were significantly associated with margin-negative resection (p < 0.001). R0 resection rates were 75% (43/57), 6% (3 of 48), for resectable or borderline resectable, and unresectable disease, respectively (p < 0.001).
Article Details
Keywords
Panceatic head adenocarcinoma, NCCN criteria, MSCT, Resectability
References
2. Phạm Văn Định. Mô Học. Nhà xuất bản Y học Hà Nội; 2002.
3. Gustavo Raichholz S. Segmental anatomy of the pancreas and its developmental variants. Imagenes. 2016; 5(13): 43-52.
4. Gilabert M, Boher JM, Raoul JL, et al. Comparison of preoperative imaging and pathological findings for pancreatic head adenocarcinoma: A retrospective analysis by the Association Française de Chirurgie. Medicine (Baltimore).2017; 96(24): e7214.
5. Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic Adenocarcinoma, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2021; 19(4): 439-457.
6. Schlitter AM, Esposito I. Definition of Microscopic Tumor Clearance (R0) in Pancreatic Cancer Resections. Cancers. 2010; 2(4): 2001-2010.
7. Chiang KC, Lee CH, Yeh CN, et al. A novel role of the tumor size in pancreatic cancer as an ancillary factor for predicting resectability. J Cancer Res Ther. 2014; 10(1): 142.
8. Maeda S, Moore AM, Yohanathan L, et al. Impact of resection margin status on survival in pancreatic cancer patients after neoadjuvant treatment and pancreatoduodenectomy. Surgery. 2020; 167(5): 803-811.
9. Hwang SH, Kim HY, Lee EJ, et al. Preoperative Clinical and Computed Tomography (CT)-Based Nomogram to Predict Oncologic Outcomes in Patients with Pancreatic Head Cancer Resected with Curative Intent: A Retrospective Study. J Clin Med. 2019; 8(10).
10. Hong SB, Lee SS, Kim JH, et al. Pancreatic Cancer CT: Prediction of Resectability according to NCCN Criteria. Radiology. 2018; 289(3): 710-718.
11. Azzaz HEM, Abdullah MS, Habib RM. Role of multidetector computed tomography in evaluation of resectability of pancreatic cancer. Egypt J Radiol Nucl Med. 2021; 52(1): 140.
12. Soydan L. Computed Tomography Prediction Of Resectability Of Pancreatic Adeno-Carcinoma Using National Comprehensive Cancer Network Criteria. Haydarpasa Numune Train Res Hosp Med J. Published online 2021.
13. Brugel M, Link TM, Rummeny EJ, Lange P, Theisen J, Dobritz M. Assessment of vascular invasion in pancreatic head cancer with multislice spiral CT: value of multiplanar reconstructions. Eur Radiol. 2004; 14(7): 1188-1195.