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Pancreatic Neoplasms: HELP
Articles by Niccolo' Napoli
Based on 9 articles published since 2010
(Why 9 articles?)
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Between 2010 and 2020, Niccolò Napoli wrote the following 9 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Robotic pancreatoduodenectomy with vascular resection. 2016

Kauffmann, Emanuele F / Napoli, Niccolò / Menonna, Francesca / Vistoli, Fabio / Amorese, Gabriella / Campani, Daniela / Pollina, Luca Emanuele / Funel, Niccola / Cappelli, Carla / Caramella, Davide / Boggi, Ugo. ·Division of General and Transplant Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy. · Division of Anesthesia and Intensive Care, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. · Division of Pathology, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. · Division of Radiology, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. · Division of General and Transplant Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy. u.boggi@med.unipi.it. ·Langenbecks Arch Surg · Pubmed #27553112.

ABSTRACT: PURPOSE: This study aims to define the current status of robotic pancreatoduodenectomy (RPD) with resection and reconstruction of the superior mesenteric/portal vein (RPD-SMV/PV). METHODS: Our experience on RPD, including RPD-SMV/PV, is presented along with a description of the surgical technique and a systematic review of the literature on RPD-SMV/PV. RESULTS: We have performed 116 RPD and 14 RPD-SMV/PV. Seven additional cases of RPD-SMV/PV were identified in the literature. In our experience, RPD and RPD-SMV/PV were similar in all baseline variables, but lower mean body mass and higher prevalence of pancreatic cancer in RPD-SMV/PV. Regarding the type of vein resection, there were one type 2 (7.1 %), five type 3 (35.7 %) and eight type 4 (57.2 %) resections. As compared to RPD, RPD-SMV/PV required longer operative time, had higher median estimated blood loss, and blood transfusions were required more frequently. Incidence and severity of post-operative complications were not increased in RPD-SMV/PV, but post-pancreatectomy hemorrhage occurred more frequently after this procedure. In pancreatic cancer, RPD-SMV/PV was associated with a higher mean number of examined lymph nodes (60.0 ± 13.9 vs 44.6 ± 11.0; p = 0.02) and with the same rate of microscopic margin positivity (25.0 % vs 26.1 %). Mean length or resected vein was 23.1 ± 8.08 mm. Actual tumour infiltration was discovered in ten patients (71.4 %), reaching the adventitia in four patients (40.0 %), the media in two patients (20.0 %), and the intima in four patients (40.0 %). Literature review identified seven additional cases, all reported to have successful outcome. CONCLUSIONS: RPD-SMV/PV is feasible in carefully selected patients. The generalization of these results remains to be demonstrated.

2 Article Tumor Regression Grading Assessment in Locally Advanced Pancreatic Cancer After Neoadjuvant FOLFIRINOX: Interobserver Agreement and Prognostic Implications. 2020

Cacciato Insilla, Andrea / Vivaldi, Caterina / Giordano, Mirella / Vasile, Enrico / Cappelli, Carla / Kauffmann, Emanuele / Napoli, Niccolò / Falcone, Alfredo / Boggi, Ugo / Campani, Daniela. ·Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy. · Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy. · Division of Medical Oncology, Pisa University Hospital, Pisa, Italy. · Diagnostic and Interventional Radiology, Pisa University Hospital, Pisa, Italy. · Department of Transplant and General Surgery, University of Pisa, Pisa, Italy. ·Front Oncol · Pubmed #32117724.

ABSTRACT: Neoadjuvant therapy represents an increasingly used strategy in pancreatic cancer, and this means that more pancreatic resections need to be evaluated for therapy effect. Several grading systems have been proposed for the histological assessment of tumor regression in pre-treated patients with pancreatic cancer, but issues like practical application, level of agreement and prognostic significance are still debated. To date, a standardized and widely accepted score has not been established yet. In this study, two pathologists with expertise in pancreatic cancer used 4 of the most frequently reported systems (College of American Pathologists, Evans, MD Anderson, and Hartman) to evaluate tumor regression in 29 locally advanced pancreatic cancers previously treated with modified FOLFIRINOX regimen, to establish the level of agreement between pathologists and to determine their potential prognostic value. Cases were additionally evaluated with a fifth grading system inspired to the Dworak score, normally used for colo-rectal cancer, to identify an alternative, relevant option. Results obtained for current grading systems showed different levels of agreement, and they often proved to be very subjective and inaccurate. In addition, no significant correlation was observed with survival. Interestingly, Dworak score showed a higher degree of concordance and a significant correlation with overall survival in individual assessments. These data reflect the need to re-evaluate grading systems for pancreatic cancer to establish a more reproducible and clinically relevant score.

3 Article Early Tumor Shrinkage and Depth of Response Evaluation in Metastatic Pancreatic Cancer Treated with First Line Chemotherapy: An Observational Retrospective Cohort Study. 2019

Vivaldi, Caterina / Fornaro, Lorenzo / Cappelli, Carla / Pecora, Irene / Catanese, Silvia / Salani, Francesca / Cacciato Insilla, Andrea / Kauffmann, Emanuele / Donati, Francescamaria / Pasquini, Giulia / Massa, Valentina / Napoli, Niccolò / Lencioni, Monica / Boraschi, Piero / Campani, Daniela / Boggi, Ugo / Caramella, Davide / Falcone, Alfredo / Vasile, Enrico. ·Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Via Savi 6, 56126 Pisa, Italy. caterinavivaldi@gmail.com. · Division of Medical Oncology, Pisa University Hospital, Via Roma 67, 56126 Pisa, Italy. caterinavivaldi@gmail.com. · Division of Medical Oncology, Pisa University Hospital, Via Roma 67, 56126 Pisa, Italy. · Department of Diagnostic Imaging, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy. · Department of Surgical, Medical, Molecular Pathology and Critical Area, Division of Surgical Pathology, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy. · Department of Transplant and General Surgery, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy. · Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy. · Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Via Savi 6, 56126 Pisa, Italy. ·Cancers (Basel) · Pubmed #31277449.

ABSTRACT: Early tumor shrinkage (ETS) and depth of response (DoR) predict favorable outcomes in metastatic colorectal cancer. We aim to evaluate their prognostic role in metastatic pancreatic cancer (PC) patients treated with first-line modified-FOLFIRINOX (FOLFOXIRI) or Gemcitabine + Nab-paclitaxel (GemNab). Hence, 138 patients were tested for ETS, defined as a ≥20% reduction in the sum of target lesions' longest diameters (SLD) after 6-8 weeks from baseline, and DoR, i.e., the maximum percentage shrinkage in the SLD from baseline. Association of ETS and DoR with progression-free survival (PFS) and overall survival (OS) was assessed. ETS was reached in 49 patients (39.5% in the FOLFOXIRI, 29.8% in the GemNab group;

4 Article A propensity score-matched analysis of robotic versus open pancreatoduodenectomy for pancreatic cancer based on margin status. 2019

Kauffmann, Emanuele F / Napoli, Niccolò / Menonna, Francesca / Iacopi, Sara / Lombardo, Carlo / Bernardini, Juri / Amorese, Gabriella / Cacciato Insilla, Andrea / Funel, Niccola / Campani, Daniela / Cappelli, Carla / Caramella, Davide / Boggi, Ugo. ·Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. · Division of Anesthesia and Intensive Care, University of Pisa, Pisa, Italy. · Division of Pathology, University of Pisa, Pisa, Italy. · Division of Radiology, University of Pisa, Pisa, Italy. · Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. u.boggi@med.unipi.it. · Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Via Paradisa 2, 56124, Pisa, Italy. u.boggi@med.unipi.it. ·Surg Endosc · Pubmed #29943061.

ABSTRACT: BACKGROUND: No study has shown the oncologic non-inferiority of robotic pancreatoduodenectomy (RPD) versus open pancreatoduodenectomy (OPD) for pancreatic cancer (PC). METHODS: This is a single institution propensity score matched study comparing RPD and ODP for resectable PC, based on factors predictive of R1 resection (≤ 1 mm). Only patients operated on after completion of the learning curve in both procedures and for whom circumferential margins were assessed according to the Leeds pathology protocol were included. The primary study endpoint was the rate of R1 resection. Secondary study endpoints were as follows: number of examined lymph nodes (N), rate of perioperative transfusions, percentage of patients receiving adjuvant therapies, occurrence of local recurrence, overall survival, disease-free survival, and sample size calculation for randomized controlled trials (RCT). RESULTS: Factors associated with R1 resection were tumor diameter, number of positive N, N ratio, logarithm odds of positive N, and duodenal infiltration. The matching process identified 20 RPDs and 24 OPDs. All RPDs were completed robotically. R1 resection was identified in 11 RPDs (55.0%) and in 10 OPDs (41.7%) (p = 0.38). There was no difference in the rate of R1 at each margin as well as in the proportion of patients with multiple R1 margins. RPD and OPD were also equivalent with respect to all secondary study endpoints, with a trend towards lower rate of blood transfusions in RPD. Based on the figures presented herein, a non-inferiority RCT comparing RPD and OPD having the rate of R1 resection as the primary study endpoint requires 3355 pairs. CONCLUSIONS: RPD and OPD achieved the same rate of R1 resections in resectable PC. RPD was also non-inferior to OPD with respect to all secondary study endpoints. Because of the high number of patients required to run a RCT, further assessment of RPD for PC would require the implementation of an international registry.

5 Article Evolution of pancreatectomy with en bloc venous resection for pancreatic cancer in Italy. Retrospective cohort study on 425 cases in 10 pancreatic referral units. 2018

Nigri, Giuseppe / Petrucciani, Niccolò / Pinna, Antonio Daniele / Ravaioli, Matteo / Jovine, Elio / Minni, Francesco / Grazi, Gian Luca / Chirletti, Piero / Balzano, Gianpaolo / Ferla, Fabio / De Carlis, Luciano / Tisone, Giuseppe / Napoli, Niccolò / Boggi, Ugo / Ramacciato, Giovanni. ·General Surgery and Hepato-pancreato-biliary Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Electronic address: giuseppe.nigri@uniroma1.it. · General Surgery and Hepato-pancreato-biliary Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. · General Surgery and Transpantation Unit, University of Bologna, Policlinico Sant'Orsola Malpighi, Bologna, Italy. · General Surgery Unit, Ospedale Maggiore di Bologna, Italy. · General Surgery Unit, Policlinico Sant'Orsola Malpighi, Bologna, Italy. · Hepato-pancreato-biliary Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy. · General Surgery Unit, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy. · Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy. · Transplantation Unit, University of Tor Vergata, Policlinico Tor Vergata, Roma, Italy. · General Surgery and Transplantation Unit, University of Pisa, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. ·Int J Surg · Pubmed #29803770.

ABSTRACT: INTRODUCTION: The aim of this study is to analyze the evolution of pancreatectomy with venous resection in 10 referral Italian centers in the last 25 years. METHODS: A multicenter database of 425 patients submitted to pancreatectomy with venous resection between 1991 and 2015 was retrospectively analyzed. Patients were classified in 5 periods: 1 (1991-1995); 2 (1996-2000); 3 (2001-2005); 4 (2006-2010); 5 (2011-2015). Indications and outcomes were compared according to the period of surgery. RESULTS: Nineteen patients were operated in period 1, 28 in period 2, 91 in period 3, 140 in period 4, and 147 in period 5. Use of neoadjuvant therapy increased from 0% in period 1 and 2-12.1% in period 5. Postoperative complications ranged from 46.3% to 67.8%, and mortality from 5.3% to 9.2%. Median survival progressively increased, from 6 months in period 1-16 months in period 2, 24 months in period 3 and 4 and 35 months in period 5 (p = 0.004). Period, venous and nodal invasion were significant prognostic factors for survival. CONCLUSION: Management and outcomes of pancreatectomy with venous resection have evolved in the last 25 years in Italy. Improvement in patients' multidisciplinary management has lead to significant improvement of median survival.

6 Article Prognostic role of nodal ratio, LODDS, pN in patients with pancreatic cancer with venous involvement. 2017

Ramacciato, Giovanni / Nigri, Giuseppe / Petrucciani, Niccolo' / Pinna, Antonio Daniele / Ravaioli, Matteo / Jovine, Elio / Minni, Francesco / Grazi, Gian Luca / Chirletti, Piero / Tisone, Giuseppe / Ferla, Fabio / Napoli, Niccolo' / Boggi, Ugo. ·Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, General Surgery Unit, Via di Grottarossa 1037, 00189, Rome, Italy. · Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, General Surgery Unit, Via di Grottarossa 1037, 00189, Rome, Italy. giuseppe.nigri@uniroma1.it. · Department of Medical and Surgical Sciences-DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, General Surgery and Transplantation Unit, Bologna, Italy. · General Surgery Unit, 'Maggiore' Hospital, Bologna, Italy. · Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S. Orsola-Malpighi Hospital, University of Bologna, General Surgery Unit, Bologna, Italy. · Regina Elena National Cancer Institute IFO, Hepato-pancreato-biliary Surgery Unit, Rome, Italy. · Department of Surgical Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, General Surgery Unit, Rome, Italy. · Department of Experimental Medicine and Surgery, Liver Unit, Tor Vergata University of Rome, Rome, Italy. · Division of General Surgery and Transplantation Surgery, Niguarda Hospital, Milan, Italy. · Division of General Surgery and Transplantation Surgery, Pisa University Hospital, Pisa, Italy. ·BMC Surg · Pubmed #29169392.

ABSTRACT: BACKGROUND: The UICC/AJCC TNM staging system classifies lymph nodes as N0 and N1 in pancreatic cancer. Aim of the study is to determine whether the number of examine nodes, the nodal ratio (NR) and the logarithm odds of positive lymph nodes (LODDS) may better stratify the prognosis of patients undergoing pancreatectomy combined with venous resection for pancreatic cancer with venous involvement. METHODS: A multicenter database of 303 patients undergoing pancreatectomy in 9 Italian referral centers was analyzed. The prognostic impact of number of retrieved and examined nodes, NR, LODDS was analyzed and compared with ROC curves analysis, Pearson test, univariate and multivariate analysis. RESULTS: The number of metastatic nodes, pN, the NR and LODDS was significantly correlated with survival at multivariate analyses. The corresponding AUC for the number of metastatic nodes, pN, the NR and LODDS were 0.66, 0.69, 0.63 and 0.65, respectively. The Pearson test showed a significant correlation between the number of retrieved lymph nodes and number of metastatic nodes, pN and the NR. LODDS had the lower coefficient correlation. Concerning N1 patients, the NR, the LODDS and the number of metastatic nodes were able to significantly further stratify survival (p = 0.040; p = 0.046; p = 0.038, respectively). CONCLUSIONS: The number of examined lymph nodes, the NR and LODDS are useful for further prognostic stratification of N1 patients in the setting of pancreatectomy combined with PV/SMV resection. No superiority of one over the others methods was detected.

7 Article Indications, technique, and results of robotic pancreatoduodenectomy. 2016

Napoli, Niccolò / Kauffmann, Emanuele F / Menonna, Francesca / Perrone, Vittorio Grazio / Brozzetti, Stefania / Boggi, Ugo. ·Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. · Pietro Valdoni Department of Surgery, University of Rome La Sapienza, Rome, Italy. · Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. u.boggi@med.unipi.it. ·Updates Surg · Pubmed #27614901.

ABSTRACT: Robotic assistance improves surgical dexterity in minimally invasive operations, especially when fine dissection and multiple sutures are required. As such, robotic assistance could be rewarding in the setting of robotic pancreatoduodenectomy (RPD). RPD was implemented at a high volume center with preemptive experience in advanced laparoscopy. Indications, surgical technique, and results of RPD are discussed against the background of current literature. RPD was performed in 112 consecutive patients. Conversion to open surgery was required in three patients, despite nine required segmental resection and reconstruction of the superior mesenteric/portal vein. No patient was converted to laparoscopy. A pancreato-jejunostomy was created in 106 patients (94.6 %), using either a duct-to-mucosa (n = 82; 73.2 %) or an invaginating (n = 24; 21.4 %) technique. Pancreato-gastrostomy was performed in one patient, the pancreatic duct was occluded in two patients, and a pancreatico-cutaneous fistula was created in three patients. Mean operative time was 526.3 ± 102.4 in the entire cohort and reduced significantly over the course of time. Experience was also associated with reduced rates of delayed gastric emptying and increased proportion of malignant tumor histology. Ninety day mortality was 3.6 %. Postoperative complications occurred in 83 patients (74.1 %) with a median comprehensive complication index of 20.9 (0-30.8). Clinically relevant pancreatic fistula occurred in 19.6 % of the patients. No grade C pancreatic fistula was noted in the last 72 consecutive patients. RPD is safely feasible in selected patients. Implementation of RPD requires sound experience with open pancreatoduodenectomy and advanced laparoscopic procedures, as well as specific training with the robotic platform.

8 Article Robotic-Assisted Pancreatic Resections. 2016

Boggi, Ugo / Napoli, Niccolò / Costa, Francesca / Kauffmann, Emanuele F / Menonna, Francesca / Iacopi, Sara / Vistoli, Fabio / Amorese, Gabriella. ·Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. u.boggi@med.unipi.it. · Division of General and Transplant Surgery, University of Pisa, Pisa, Italy. · Division of Anesthesia and Intensive Care, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. ·World J Surg · Pubmed #27206401.

ABSTRACT: BACKGROUND: Robotic assistance enhances surgical dexterity and could facilitate wider adoption of laparoscopy for pancreatic resections (PR). METHODS: Data were prospectively entered into a database and analyzed retrospectively to assess feasibility and safety of robotic-assisted PR (RAPR). Additionally, robotic-assisted pancreaticoduodenectomy (RAPD) was compared to a contemporary group of open pancreaticoduodenectomies (OPD). RESULTS: Between October 2008 and October 2014, 200 consecutive patients underwent RAPR. Three procedures were converted to open surgery (1.5 %), despite 14 patients required associated vascular procedures. RAPD was performed in 83 patients (41.5 %), distal pancreatectomy in 83 (41.5 %), total pancreatectomy in 17 (8.5 %), tumor enucleation in 12 (6 %), and central pancreatectomy in 5 (2.5 %). Thirty-day and 90-day mortality rates were 0.5 and 1 %, respectively. Both deaths occurred after RAPD with vein resection. Complications occurred in 63.0 % of the patients (≥Clavien-Dindo grade IIIb in 4 %). Median comprehensive complication index was 20.9 (0-26.2). Incidence of grade B/C pancreatic fistula was 28.0 %. Reoperation was required in 14 patients (7.0 %). The risk of reoperation decreased after post-operative day 20 (OR 0.072) (p = 0.0015). When compared to OPD, RAPD was associated with longer mean operative time (527.2 ± 166.1 vs. 425.3 ± 92.7; <0.0001) but had an equivalent safety profile. The median number of examined lymph nodes (37; 28.8-45.3 vs. 36; 28-52.8) and the rate of margin positivity in patients diagnosed with pancreatic cancer were also similar (12.5 vs. 45.5 %). CONCLUSIONS: RAPR, including RAPD, are safely feasible in selected patients. The results of RAPD in pancreatic cancer are encouraging but deserve further investigation.

9 Article Pancreatectomy with Mesenteric and Portal Vein Resection for Borderline Resectable Pancreatic Cancer: Multicenter Study of 406 Patients. 2016

Ramacciato, Giovanni / Nigri, Giuseppe / Petrucciani, Niccolò / Pinna, Antonio Daniele / Ravaioli, Matteo / Jovine, Elio / Minni, Francesco / Grazi, Gian Luca / Chirletti, Piero / Tisone, Giuseppe / Napoli, Niccolò / Boggi, Ugo. ·Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, General Surgery Unit, Rome, Italy. · Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, General Surgery Unit, Rome, Italy. giuseppe.nigri@uniroma1.it. · Department of Medical and Surgical Sciences-DIMEC, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, General Surgery and Transplantation Unit, Bologna, Italy. · General Surgery Unit, 'Maggiore' Hospital, Bologna, Italy. · Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S. Orsola-Malpighi Hospital, University of Bologna, General Surgery Unit, Bologna, Italy. · Regina Elena National Cancer Institute IFO, Hepato-pancreato-biliary Surgery Unit, Rome, Italy. · Department of Surgical Sciences, Sapienza University of Rome, Policlinico Umberto I Hospital, General Surgery Unit, Rome, Italy. · Department of Experimental Medicine and Surgery, Liver Unit, Tor Vergata University of Rome, Rome, Italy. · Division of General and Transplant Surgery, Pisa University Hospital, Pisa, Italy. ·Ann Surg Oncol · Pubmed #26893222.

ABSTRACT: PURPOSE: The role of pancreatectomy with en bloc venous resection and the prognostic impact of pathological venous invasion are still debated. The authors analyzed perioperative, survival results, and prognostic factors of pancreatectomy with en bloc portal (PV) or superior mesenteric vein (SMV) resection for borderline resectable pancreatic carcinoma, focusing on predictive factors of histological venous invasion and its prognostic role. METHODS: A multicenter database of 406 patients submitted to pancreatectomy with en bloc SMV and/or PV resection for pancreatic adenocarcinoma was analyzed retrospectively. Univariate and multivariate analysis of factors related to histological venous invasion were performed using logistic regression model. Prognostic factors were analyzed with log-rank test and multivariate proportional hazard regression analysis. RESULTS: Complications occurred in 51.9 % of patients and postoperative death in 7.1 %. Histological invasion of the resected vein was confirmed in 56.7 % of specimens. Five-year survival was 24.4 % with median survival of 24 months. Vein invasion at preoperative computed tomography (CT), N status, number of metastatic lymph nodes, preoperative serum albumin were related to pathological venous invasion at univariate analysis, and vein invasion at CT was independently related to venous invasion at multivariate analysis. Use of preoperative biliary drain was significantly associated with postoperative complications. Multivariate proportional hazard regression analysis demonstrated a significant correlation between overall survival and histological venous invasion and administration of adjuvant therapy. CONCLUSIONS: This study identifies predictive factors of pathological venous invasion and prognostic factors for overall survival, including pathological venous invasion, which may help with patients' selection for different treatment protocols.