Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.
S, K., T, T., A, F., H, K., K, H., Y, S., M, H., M, S., S, T., & T, N. (2026). Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.. Journal of gastrointestinal cancer. https://doi.org/10.1007/s12029-026-01527-6
S K, T T, A F, H K, K H, Y S, et al. Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.. Journal of gastrointestinal cancer. 2026; doi: 10.1007/s12029-026-01527-6
S K, T T, A F, et al. Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.[J]. Journal of gastrointestinal cancer. 2026. DOI: 10.1007/s12029-026-01527-6.
@article{s2026,
author = {Kozono S and Tatsuguchi T and Fujii A and Kuga H and Hirahata K and Shimokawa Y and Hijioka M and Sakamoto M and Tamiya S and Nakano T},
title = {Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.},
journal = {Journal of gastrointestinal cancer},
year = {2026},
doi = {10.1007/s12029-026-01527-6},
note = {PMID: 42461335},
}
TY - JOUR AU - Kozono S AU - Tatsuguchi T AU - Fujii A AU - Kuga H AU - Hirahata K AU - Shimokawa Y AU - Hijioka M AU - Sakamoto M AU - Tamiya S AU - Nakano T TI - Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer. T2 - Journal of gastrointestinal cancer PY - 2026 DO - 10.1007/s12029-026-01527-6 AN - PMID:42461335 ER -
PURPOSE: To investigate whether preoperative computed tomography (CT)-based tumor-portal/superior mesenteric vein (PV/SMV) contact angle and contact length predict pathological venous invasion and refine prognostic stratification in anatomically resectable pancreatic ductal adenocarcinoma (R-PDAC). METHODS: We retrospectively reviewed 108 patients who underwent upfront pancreaticoduodenectomy without neoadjuvant chemotherapy for pancreatic head PDAC, including 101 anatomically resectable cases and 7 borderline resectable cases with PV involvement (BR-PV). Tumor-PV/SMV contact angle and contact length were measured on multidetector CT. Their associations with pathological PV/SMV invasion, PV/SMV resection, and overall survival (OS) were analyzed. RESULTS: Both contact angle and contact length predicted pathological venous invasion, with optimal cutoff values of 90° for angle (AUC = 0.86) and 15 mm for length (AUC = 0.84), and both were significantly associated with pathological venous invasion and PV/SMV resection (all p < 0.001). In the subgroup with R-PDAC, however, only contact length provided meaningful prognostic stratification. Patients with contact length ≥ 15 mm had significantly worse OS than those with contact length < 15 mm (p = 0.0032) or no contact (p < 0.001), and their survival was comparable to that of BR-PV patients (p = 0.8548). In multivariable analysis, contact length ≥ 15 mm remained an independent adverse prognostic factor (HR 2.79, 95% CI 1.64-4.73, p < 0.001). CONCLUSION: Preoperative CT-based assessment of tumor-PV/SMV contact length may serve as a practical marker for identifying a high-risk subgroup within R-PDAC and may help refine selection of patients for neoadjuvant treatment.