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Comparison of preoperative imaging and pathological findings for pancreatic head adenocarcinoma: A retrospective analysis by the Association Française de Chirurgie.

Abstract Initial imaging of pancreatic ductal adenocarcinoma is of crucial importance in the decision-making process. The aim of this study was to compare preoperative imaging, pathological data, and outcomes in a series of patients who underwent resection for pancreatic head cancer.From January 2004 to December 2009, data were collected by the Association Française de Chirurgie on 1044 patients who received first-line R0 resection of pancreatic head cancer.On imaging (computed tomography scan 97%, echoendoscopic ultrasound 61.3%, magnetic resonance imaging 46.5%), arterial, venous, or lymph node invasion was suspected in 20, 161, and 197 patients, respectively; arterial, venous, or lymph node invasion was observed histologically in 11, 116, and 736 cases, respectively. In the patients for whom both imaging and pathological data were available, the concordance, sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 97.5%, 27.3%, 98%, 20%, and 99%, for arterial invasion; 86.5%, 54%, 91%, 47.8%, and 93.2%, for venous invasion; and 38%, 21%, 86%, 78%, and 41%, respectively, for lymph node invasion. Imaging of arterial invasion had no prognostic value, while histological evidence of invasion was associated with a poor prognosis. Venous and lymph node invasion, as demonstrated by imaging and by pathological analysis, had an adverse prognostic value.Imaging gives a fair positive predictive value for venous or arterial invasion; venous invasion on imaging and histology was associated with a poor prognosis; arterial invasion on imaging does not have any significant prognostic value.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28614269
OWN - NLM
STAT- MEDLINE
DA  - 20170614
DCOM- 20170706
LR  - 20170706
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 24
DP  - 2017 Jun
TI  - Comparison of preoperative imaging and pathological findings for pancreatic head 
      adenocarcinoma: A retrospective analysis by the Association Francaise de
      Chirurgie.
PG  - e7214
LID - 10.1097/MD.0000000000007214 [doi]
AB  - Initial imaging of pancreatic ductal adenocarcinoma is of crucial importance in
      the decision-making process. The aim of this study was to compare preoperative
      imaging, pathological data, and outcomes in a series of patients who underwent
      resection for pancreatic head cancer.From January 2004 to December 2009, data
      were collected by the Association Francaise de Chirurgie on 1044 patients who
      received first-line R0 resection of pancreatic head cancer.On imaging (computed
      tomography scan 97%, echoendoscopic ultrasound 61.3%, magnetic resonance imaging 
      46.5%), arterial, venous, or lymph node invasion was suspected in 20, 161, and
      197 patients, respectively; arterial, venous, or lymph node invasion was observed
      histologically in 11, 116, and 736 cases, respectively. In the patients for whom 
      both imaging and pathological data were available, the concordance, sensitivity, 
      specificity, positive predictive value, and negative predictive value were as
      follows: 97.5%, 27.3%, 98%, 20%, and 99%, for arterial invasion; 86.5%, 54%, 91%,
      47.8%, and 93.2%, for venous invasion; and 38%, 21%, 86%, 78%, and 41%,
      respectively, for lymph node invasion. Imaging of arterial invasion had no
      prognostic value, while histological evidence of invasion was associated with a
      poor prognosis. Venous and lymph node invasion, as demonstrated by imaging and by
      pathological analysis, had an adverse prognostic value.Imaging gives a fair
      positive predictive value for venous or arterial invasion; venous invasion on
      imaging and histology was associated with a poor prognosis; arterial invasion on 
      imaging does not have any significant prognostic value.
FAU - Gilabert, Marine
AU  - Gilabert M
AD  - aDepartment of Medical Oncology, Paoli-Calmettes Institute bClinical Trial Office
      and Biostatistics Unit, Paoli-Calmettes Institute, Marseille cDepartment of
      Digestive Surgery, Hopital Saint-Antoine, Paris dHepatobiliary Surgery and Liver 
      Transplantation, Hopital Universitaire de Strasbourg, Strasbourg eDepartment of
      Digestive Surgery, Paoli-Calmettes Institute, Marseille, France.
FAU - Boher, Jean-Marie
AU  - Boher JM
FAU - Raoul, Jean-Luc
AU  - Raoul JL
FAU - Paye, Francois
AU  - Paye F
FAU - Bachellier, Philippe
AU  - Bachellier P
FAU - Turrini, Olivier
AU  - Turrini O
FAU - Delpero, Jean Robert
AU  - Delpero JR
CN  - Association Francaise de Chirurgie
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - Pancreatic Carcinoma
SB  - AIM
SB  - IM
MH  - Adenocarcinoma/*diagnostic imaging/*pathology/surgery
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Disease-Free Survival
MH  - Endosonography
MH  - Europe
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis/diagnostic imaging/pathology
MH  - Pancreas/diagnostic imaging/pathology/surgery
MH  - Pancreatic Neoplasms/*diagnostic imaging/*pathology/surgery
MH  - Preoperative Period
MH  - Prognosis
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Tomography, X-Ray Computed
PMC - PMC5478354
EDAT- 2017/06/15 06:00
MHDA- 2017/07/07 06:00
CRDT- 2017/06/15 06:00
AID - 10.1097/MD.0000000000007214 [doi]
AID - 00005792-201706160-00055 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(24):e7214. doi: 10.1097/MD.0000000000007214.