Superior mesenteric artery boundary characteristics predicts postoperative survival status in pancreatic head ductal adenocarcinoma / 中华普通外科杂志

ABSTRACT

Objective To examine whether the boundary patterns of the superior mesenteric artery (SMA) in the preoperative contrasted enhanced computer tomography (CE-CT) could predict poor postoperative prognosis.Methods From January 2010 to December 2015,104 patients of pancreatic head ductal adenocarcinoma received radical pancreaticoduodenectomy by a single group of surgeons.All patients underwent CE-CT before operation.The clinicopathological characteristics and the prognosis were comparatively analyzed among the patients with different SMA boundary patterns.Results The patients with obscure SMA boundary in CE-CT had a lower overall survival rate (P =0.012) and a higher liver metastasis rate (P ＜ 0.01) compared to the patients with clear SMA boundary.38.2％ of patients with obscure SMA boundary died within 6 months,69.1％ of them died within 12 months while the mortality rate was 6％ within 6 months and 29.2％ within 12 months in patients with clear SMA boundary.Only 2.2％ of patients with clear SMA boundary presented liver metastasis within 6 months,but that was 53％ in patients with obscure SMA boundary.18.4％ of patients developed liver metastasis within 12 months in patients with clear SMA boundary,whereas the rate was 82％ in patients with obscure SMA boundary.Furthermore,the tissues around the SMA presented a higher CT value in any phase in patients with obscure SMA boundary than in patients with clear SMA boundary (P ＜ 0.01).Conclusions The patterns of the SMA boundary in CE-CT is a potential prognostic factor in pancreatic head ductal adenocarcinoma after radical operation,and the obscure SMA boundary may be associated with early liver metastasis and high mortality.