• Yoshiaki Murakami, Sohei Satoi, Masayuki Sho, Fuyuhiko Motoi, Ippei Matsumoto, Manabu Kawai, Goro Honda, Kenichiro Uemura, Hiroaki Yanagimoto, Makoto Shinzeki, Masanao Kurata, Shoichi Kinoshita, Hiroki Yamaue, and Michiaki Unno.
• Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan, mura777@hiroshima-u.ac.jp.
• World J Surg. 2015 Sep 1; 39 (9): 2306-14.

BackgroundThe aim of this study was to evaluate the validity of preoperative resectability status, as defined by the National Comprehensive Cancer Network (NCCN), from the viewpoint of overall survival.MethodsA total of consecutive 704 patients with pancreatic head carcinoma who underwent pancreatoduodenectomy with upfront surgery at seven Japanese hospitals between 2001 and 2012 were evaluated retrospectively. According to the NCCN definition of preoperative resectability status, tumors were divided into resectable tumors without vascular contact (R group), resectable tumors with portal or superior mesenteric vein (PV/SMV) contact of ≦180° (R-PV group), borderline resectable(BR) tumors with PV/SMV contact of >180° (BR-PV group), and BR tumors with arterial contact (BR-A group). The relationship between the NCCN definition of preoperative resectability status and overall survival was analyzed.ResultsOf the 704 patients, 389, 114, 145, and 56 were classified into the R group, the R-PV group, the BR-PV group, and the BR-A group, respectively. Overall survival of the BR-PV and BR-A groups was significantly worse than that of the R group and R-PV groups (P < 0.05), although there was no significant difference in overall survival between the R group and the R-PV group (P = 0.310). Multivariate analysis revealed that PV/SMV contact of >180° (P = 0.008) and arterial contact (P < 0.001) were independent prognostic factors of overall survival.ConclusionFrom the viewpoint of overall survival, the NCCN definition of preoperative resectability status was valid.

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