A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy

Table 1

Comparison of preoperative characteristics between PD and PD-SAR.

Variable	PD (𝑛=66)	PD-SAR (𝑛=18)	𝑃 value
Gender
Male	43	6	0.029
Female	23	12
Age (years)	66.5±9.6	67.6±9.2	0.718
Tumor size before treatment (mm)	30.8±8.7	37.8±10.9	0.030
UICC-T3	40 (61.7%)	6 (33.3%)	0.060
UICC-T4	26 (39.3%)	12 (66.7%)
Resectability			0.124
R	6	1
BR	49	10
UR	11	7
Cancer involvement of major vessels
SMV/PV	59 (89.4%)	16 (88.9%)	0.713
SMA	20 (30.3%)	5 (27.8%)	0.934
HA	8 (12.1%)	8 (44.4%)	0.006
CeA	6 (9.0%)	6 (33.3%)	0.026
SA	0 (0%)	18 (100%)	<0.001
Ao/IVC	2 (3.0%)	1 (5.6%)	0.838
Treatment before surgery
G-CRT	35 (53.0%)	11 (61.1%)	0.917
GS-CRT	24 (36.4%)	5 (27.8%)
CTA	3	1
Non	4	1
CA19-9 levels (U/mL)
Before preoperative treatment	620.7±1710.5	681.9±1803.3	0.878
After preoperative treatment	87.7±77.2	155.6±335.0	0.216

UICC: International Union for Cancer Control; R: resectable; BR: borderline resectable; UR: unresectable; SMV: superior mesenteric vein; PV: portal vein; SMA: superior mesenteric artery; HA: hepatic artery; CeA: celiac artery; SA: splenic artery; Ao: aorta; IVC: inferior vena cava; G-CRT: gemcitabine-based chemoradiotherapy; GS-CRT: gemcitabine plus S1-based chemoradiotherapy; CTA: chemotherapy alone; Non: no treatment before surgery.