Background : Pancreatic cancer is known for its poor prognosis; however, the implementation of neoadjuvant treatment enabled the borderline resectable cases to undergo curative resection and improved the overall survival. There are attempts to expand the eligibility criteria for neoadjuvant treatment even in resectable cases. Some studies suggest a correlation between vein abutment and poor prognosis, or that the angle of abutment may affect the prognosis. Thus, this study investigates the anatomical factor of degree of vessel abutment in angle and its prognostic effect in resectable pancreatic cancer.

Methods : From 2012 to 2017, pancreatic ductal adenocarcinoma who underwent surgery were included. Those whose vein abutment were more than 180 degrees and arterial abutment were excluded. Neoadjuvant treatment or palliative surgery groups were excluded. Only the intent-to-treat pancreaticoduodenectomy group were included for analysis. Clinicopathological characteristics, preoperative factors and intraoperative findings were collected for analysis. The degree of vein abutment was measured by abdominal part radiologist.

Results : Total of 365 patients were included in this study and abutment group was 92 patients (25.2%). Abutment group and no contact group did not have any statistical significance in terms of overall survival or disease-free survival. Among the abutment group, those with less than 90 degree and 90-180 degrees patients failed to show statistical significance. In multivariate analysis, the only preoperative prognostic effect was CA19-9, biological factor

Conclusions : When there is not involvement of vessel but only abutment group, upfront surgery should be considered since the angle did not affect the overall prognosis