Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective

BackgroundThe assessment of resectability in borderline resectable pancreatic cancer (BRPC) primarily relies on preoperative imaging, which examines the spatial association between the tumor and adjacent vital veins, particularly the portal venous system. However, venous invasion detected via imagin...

Full description

Saved in:
Bibliographic Details
Main Authors: Jin-Can Huang, Cheng-Run Zhang, Han-Xuan Wang, Shao-Cheng Lyu, Ren Lang, Tao Jiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1613153/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850060403731595264
author Jin-Can Huang
Cheng-Run Zhang
Han-Xuan Wang
Shao-Cheng Lyu
Ren Lang
Tao Jiang
author_facet Jin-Can Huang
Cheng-Run Zhang
Han-Xuan Wang
Shao-Cheng Lyu
Ren Lang
Tao Jiang
author_sort Jin-Can Huang
collection DOAJ
description BackgroundThe assessment of resectability in borderline resectable pancreatic cancer (BRPC) primarily relies on preoperative imaging, which examines the spatial association between the tumor and adjacent vital veins, particularly the portal venous system. However, venous invasion detected via imaging is rarely confirmed by postoperative pathology. This research seeks to assess the long-term results in patients with pathologically verified venous invasion and to explore the related risk factors.MethodsThis study involved 248 individuals who underwent radical pancreaticoduodenectomy (PD) from January 2011 to July 2023. Patients were classified into three categories based on preoperative imaging and postoperative pathology: no venous invasion (n = 99), imaging-suspected (n = 30), and pathology-confirmed (n = 119). Clinical features and prognoses were compared among groups. In the cohort with pathology-confirmed venous invasion, patients were further classified by invasion depth into intimal (n = 51) and non-intimal (n = 68) subgroups for risk factor analysis.ResultsPatients with pathologically confirmed venous invasion exhibited significantly reduced disease-free survival (DFS) and overall survival (OS) when compared to those with either imaging-suspected or absent venous invasion (p < 0.001). Further analysis of pathology-confirmed venous invasion patients showed significantly lower DFS (p = 0.008) and OS (p < 0.001) compared to non-intimal invasion patients. Independent risk variables for poor DFS included age ≥60 years, tumor diameter >3 cm, and intimal invasion. Independent risk factors for poor OS in patients with venous invasion included age ≥60 years, poorly differentiated tumors, intimal invasion, and TNM stage III.ConclusionIntimal venous invasion emerged as a distinct risk factor influencing postoperative survival. Radical surgical resection remains essential for attaining favorable long-term outcomes in pancreatic cancers.
format Article
id doaj-art-4222345c2aa84a78a7dcb2d8c4fcda4d
institution DOAJ
issn 2296-858X
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-4222345c2aa84a78a7dcb2d8c4fcda4d2025-08-20T02:50:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16131531613153Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspectiveJin-Can HuangCheng-Run ZhangHan-Xuan WangShao-Cheng LyuRen LangTao JiangBackgroundThe assessment of resectability in borderline resectable pancreatic cancer (BRPC) primarily relies on preoperative imaging, which examines the spatial association between the tumor and adjacent vital veins, particularly the portal venous system. However, venous invasion detected via imaging is rarely confirmed by postoperative pathology. This research seeks to assess the long-term results in patients with pathologically verified venous invasion and to explore the related risk factors.MethodsThis study involved 248 individuals who underwent radical pancreaticoduodenectomy (PD) from January 2011 to July 2023. Patients were classified into three categories based on preoperative imaging and postoperative pathology: no venous invasion (n = 99), imaging-suspected (n = 30), and pathology-confirmed (n = 119). Clinical features and prognoses were compared among groups. In the cohort with pathology-confirmed venous invasion, patients were further classified by invasion depth into intimal (n = 51) and non-intimal (n = 68) subgroups for risk factor analysis.ResultsPatients with pathologically confirmed venous invasion exhibited significantly reduced disease-free survival (DFS) and overall survival (OS) when compared to those with either imaging-suspected or absent venous invasion (p < 0.001). Further analysis of pathology-confirmed venous invasion patients showed significantly lower DFS (p = 0.008) and OS (p < 0.001) compared to non-intimal invasion patients. Independent risk variables for poor DFS included age ≥60 years, tumor diameter >3 cm, and intimal invasion. Independent risk factors for poor OS in patients with venous invasion included age ≥60 years, poorly differentiated tumors, intimal invasion, and TNM stage III.ConclusionIntimal venous invasion emerged as a distinct risk factor influencing postoperative survival. Radical surgical resection remains essential for attaining favorable long-term outcomes in pancreatic cancers.https://www.frontiersin.org/articles/10.3389/fmed.2025.1613153/fullpancreatic cancervenous invasionpathologyprognosispancreaticoduodenectomy
spellingShingle Jin-Can Huang
Cheng-Run Zhang
Han-Xuan Wang
Shao-Cheng Lyu
Ren Lang
Tao Jiang
Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
Frontiers in Medicine
pancreatic cancer
venous invasion
pathology
prognosis
pancreaticoduodenectomy
title Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
title_full Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
title_fullStr Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
title_full_unstemmed Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
title_short Prognostic implications of venous invasion in pancreatic cancer following radical surgical resection: a pathological perspective
title_sort prognostic implications of venous invasion in pancreatic cancer following radical surgical resection a pathological perspective
topic pancreatic cancer
venous invasion
pathology
prognosis
pancreaticoduodenectomy
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1613153/full
work_keys_str_mv AT jincanhuang prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective
AT chengrunzhang prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective
AT hanxuanwang prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective
AT shaochenglyu prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective
AT renlang prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective
AT taojiang prognosticimplicationsofvenousinvasioninpancreaticcancerfollowingradicalsurgicalresectionapathologicalperspective