Prognostic impact of the distance from the root of splenic artery to tumor in the patients with pancreatic body or tail cancer

Background: The impact of the distance from the root of splenic artery to tumor (DST) on the prognosis and optimal surgical procedures in the patients with pancreatic body/tail cancer has been unclear. Methods: We retrospectively analyzed 94 patients who underwent distal pancreatectomy (DP) and 17 patients who underwent DP with celiac axis resection (DP-CAR) between 2008 and 2018. Results: The 111 patients were assigned by DST length (in mm) as DST = 0: n = 14, 010: n = 18, and 1079. The median overall survival (OS) and relapse-free survival (RFS) did not significantly differ in each group. A multivariate analysis showed that DST was not an independent prognostic factor for both RFS and OS. DP-CAR did not improve the prognosis in the DST = 0 and the 010 groups. In the DST = 0 group, neoadjuvant therapy significantly decreased distant metastasis (P = 0.025) and improve the overall survival (P = 0.046). Conclusions: DST did not affect prognosis in patients with pancreatic body/tail cancer. Neoadjuvant therapy followed by DP may be desirable for patients with a DST = 0 tumor. For those with a 010 tumor, DP may be suitable; DP-CAR is an alternative when ligation and dissection of the root of the splenic artery are difficult or not possible. (c) 2023 Published by Elsevier B.V. on behalf of IAP and EPC.