Prognostic Impact of Gastroduodenal Artery Involvement in Cancer of the Pancreatic Head

Background Pancreatic ductal adenocarcinoma (PDAC) contacting major arteries such as the celiac, common hepatic, and superior mesenteric artery is linked to poor prognosis and classified as borderline resectable. Although PDAC involving the gastroduodenal artery (GDA) is considered resectable, the prognostic impact of GDA involvement remains unclear. Here we investigated the prognostic impact of GDA involvement in PDAC after resection. Methods This study included 105 patients with resectable PDAC or borderline resectable with portal vein involvement. Patients were divided into two groups: those with tumor-GDA contact <= 180 degrees and those with GDA contact > 180 degrees. We evaluated the prognostic impact of GDA involvement between these groups. Results Both recurrence-free and overall survival after the surgery were significantly poorer with GDA contact > 180 degrees than <= 180 degrees. The poorer prognosis with GDA contact > 180 degrees was verified by multivariate analysis and propensity score matching analysis to match patient backgrounds between the groups. The frequency of postoperative distant metastasis was also significantly higher in patients with GDA contact > 180 degrees. Conclusions GDA involvement is an independent factor significantly associated with postoperative survival in PDAC, and the poorer prognosis with GDA involvement may be linked to the development of postoperative distant metastasis.

Automated summary

This study demonstrates that GDA involvement is an independent factor significantly associated with postoperative survival in PDAC. Patients with GDA contact > 180 degrees have a poorer prognosis, which may be linked to the development of postoperative distant metastasis.