{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:18:20Z","timestamp":1790198300582,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T00:00:00Z","timestamp":1560384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Microvascular invasion (MVI) has been proved to be poor prognostic factor in many cancers. To date, only one study published highlights the relationship between this factor and the natural history of pancreatic cancer. The aim of this study was to assess the impact of MVI, on disease\u2010free survival (DFS) and overall survival (OS), after pancreatico\u2010duodenectomy (PD) for pancreatic head adenocarcinoma. Secondarily, we aim to demonstrate that MVI is the most important factor to predict OS after surgery compared with resection margin (RM) and lymph node (LN) status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Between January 2015 and December 2017, 158 PD were performed in two hepato\u2010bilio\u2010pancreatic (HBP) centers. Among these, only 79 patients fulfilled the inclusion criteria of the study. Clinical\u2010pathological data and outcomes were retrospectively analyzed from a prospectively maintained database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 79 patients in the cohort, MVI was identified in 35 (44.3%). In univariate analysis, MVI (<jats:italic>P<\/jats:italic>\u2009=\u2009.012 and <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001), RM (<jats:italic>P<\/jats:italic>\u2009=\u2009.023 and <jats:italic>P<\/jats:italic>\u2009=\u2009.021), and LN status (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001 and <jats:italic>P<\/jats:italic>\u2009=\u2009.0001) were significantly associated with DFS and OS. A less than 1\u2009mm margin clearance did not influence relapse (<jats:italic>P<\/jats:italic>\u2009=\u2009.72) or long\u2010term survival (<jats:italic>P<\/jats:italic>\u2009=\u2009.48). LN ratio\u2009&gt;\u20090.226 had a negative impact on OS (<jats:italic>P<\/jats:italic>\u2009=\u2009.044). In multivariate analysis, MVI and RM persisted as independent prognostic factors of DFS (<jats:italic>P<\/jats:italic>\u2009=\u2009.0075 and <jats:italic>P<\/jats:italic>\u2009=\u2009.0098, respectively) and OS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001 and <jats:italic>P<\/jats:italic>\u2009=\u2009.0194, respectively). Using the likelihood ratio test, MVI was identified as the best fit to predict OS after PD for ductal adenocarcinomas compared with the margin status model (R0 vs R1) (<jats:italic>P<\/jats:italic>\u2009=\u2009.0014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MVI represents another major prognostic factor determining long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25580","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T04:00:20Z","timestamp":1560484820000},"page":"483-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Microvascular invasion is a major prognostic factor after pancreatico\u2010duodenectomy for adenocarcinoma"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8200-4969","authenticated-orcid":false,"given":"Fabrizio","family":"Panaro","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Kellil","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Vendrell","sequence":"additional","affiliation":[{"name":"Department of Pathology and Onco\u2010Biology\/Solid Tumors Biology Lab, Arnaud de Villeneuve Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Sega","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Poliambulanza Foundation Hospital  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regis","family":"Souche","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tullio","family":"Piardi","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery Reims University Hospital\u2010School of Medicine  Reims France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piera","family":"Leon","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery, Department of Surgery, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Cassinotto","sequence":"additional","affiliation":[{"name":"Department of Radiology, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Assenat","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, Saint Eloi Hospital, School of Medicine Montpellier University Hospital  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Rosso","sequence":"additional","affiliation":[{"name":"Department of Pathology and Onco\u2010Biology\/Solid Tumors Biology Lab, Arnaud de Villeneuve Hospital, School of Medicine Montpellier University 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