Graduation Thesis

Graduation Thesis

1 General part

https://rpubs.com/alex_istrate/581223

2 Special part

2.1 Introduction

2.1.1 Objectives

2.2 Methods

2.2.1 Statistical analysis of the data

To describe the quantitative variables, we used histograms and we calculated the arithmetic means ±standard deviation (SD) [with 95% confidence interval (CI)], as well as the extreme and median values. For the qualitative variables, we used pie or bar charts and calculated the absolute and percentual frequencies of the formed categories.

To study the relationships between quantitative and qualitative variables, we used the T or Mann-Whitney (MW) tests if they were binary, respectively ANOVA or Kruskal-Wallis (KW) if they had more categories. We presented the p values generated by these tests as well as the means ±SD of the groups and the difference of the means with associated 95% CI. We graphically presented the results in the form of box plots. To study the relationships between the quantitative variables we used the Spearman correlation coefficient (R), with the associated p-value and graphically presented the relations as scatter plots, on which we added the regression line. To describe the relationships between the qualitative variables we used the Chi² or Fisher test and the Cramer phi or V and Odds-Ratio (OR) / Relative Risk (RR) indicators with 95% CI. We graphically presented the results in the form of pie or bar charts.

We used Microsoft Excel 2016 for database management. For all statistical analyzes and subsequent graphs we used R 3.6.3 [1]. We considered p <0.05 to be statistically significant and p <0.10 to show only a tendency towards statistical significance.

2.3 Results

2.3.1 Demographics

A total of 231 patients were included in the database. Their age had values between 21.9 and 87.3 years old (median: 63.25) with an average of 62.83 ±9.51 years. Most patients were women (59%). At discharge, only 5.6% died and most were considered cured (24.7%) or at least ameliorated (67.4%). At 1-Oct-2019, 40.3% would have died. About 7% of the patients received reinterventions and 33.8% underwent some vasular operation.

Table 1: Demographic parameters of the sample.

Variable	Details	Total
N=		231
Age (years)	μ ±SD	62.83 ±9.51
	M (min:max)	63.25 (21.94:87.33)
Sex	F	94 (40.7%)
	M	137 (59.3%)
Alive at 1-Oct-2019		92 (39.8%)
State at discharge	cured	53 (24.7%)
	ameliorated	145 (67.4%)
	stationary	1 (0.5%)
	aggravated	4 (1.9%)
	deceased	12 (5.6%)
Reinterventions		14 (7.1%)
Vascular operation		62 (28.8%)
Venous resection		38 (16.5%)
Arterial resection		26 (11.3%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

Figure 1: Sex distribution.

Figure 2: Age distribution, colored by sex. (| mean, ¦ median).

2.3.2 Address

Most patients lived in the Cluj county (21.2%) or neighboring counties.

Figure 3: Geographic distribution of the cases.

2.3.3 Outcomes

The average age in patients who died before 1-Oct-2019 was significantly higher than in those who did not (64.38 ±8.24 years vs. 60.62 ±10.7) according to the Mann-Whitney test (p=0.003). Mortality was not influenced by gender (p=0.587), reinterventions (p=410) or vascular operations (p=0.777).

Figure 3: State at discharge and at Oct 1, 2019.

Table 2: Main parameters of the sample, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Age (years)	μ ±SD	64.38 ±8.24	60.62 ±10.7	62.83 ±9.51	MW: p=0.003
	M (min:max)	64.68 (37.85:80.22)	61.31 (21.94:87.33)	63.25 (21.94:87.33)
Sex	F	55 (39.6%)	39 (42.4%)	94 (40.7%)	OR=0.89 [0.52, 1.52] (p=0.684)
	M	84 (60.4%)	53 (57.6%)	137 (59.3%)
State at discharge	cured	28 (22.2%)	25 (28.1%)	53 (24.7%)	V=0.22 (p=0.031)
	ameliorated	82 (65.1%)	63 (70.8%)	145 (67.4%)
	stationary	1 (0.8%)	0	1 (0.5%)
	aggravated	3 (2.4%)	1 (1.1%)	4 (1.9%)
	deceased	12 (9.5%)	0	12 (5.6%)
Reinterventions		10 (8.4%)	4 (5.1%)	14 (7.1%)	OR=1.72 [0.52, 5.69] (p=0.413)
Vascular operation		37 (28.9%)	25 (28.7%)	62 (28.8%)	OR=1.01 [0.55, 1.84] (p>0.999)
Venous resection		27 (19.4%)	11 (12.0%)	38 (16.5%)	OR=1.78 [0.83, 3.78] (p=0.150)
Arterial resection		10 (7.2%)	16 (17.4%)	26 (11.3%)	OR=0.37 [0.16, 0.85] (p=0.020)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.3.4 Vascular operation

The average age in patients who had vascular operations was significantly higher than in those who did not (60.98 ±9.28 vs. 63.74 ±9.52) according to the Mann-Whitney test (p=673). Vascular operations were not significantly correlated to gender (p=0.587), reinterventions (p=575) or living status at 1-Oct-2019 (p=0.777).

Figure 4: Patients distribution by vascular operation.

Figure 5: Patients distribution by vascular operation (arteries or veins).

Table 3: Demographic parameters of the sample, by vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
Age (years)	μ ±SD	61.78 ±9.64	63.74 ±9.52	62.83 ±9.51	MW: p=0.121
	M (min:max)	63.07 (40.28:87.33)	64.4 (21.94:80.67)	63.25 (21.94:87.33)
Sex	F	22 (35.5%)	64 (41.8%)	86 (40.0%)	OR=0.76 [0.41, 1.41] (p=0.444)
	M	40 (64.5%)	89 (58.2%)	129 (60.0%)
Alive at 1-Oct-2019		25 (40.3%)	62 (40.5%)	87 (40.5%)	OR=1.01 [0.55, 1.84] (p>0.999)
State at discharge	cured	8 (13.3%)	42 (29.8%)	50 (24.9%)	V=0.21 (p=0.055)
	ameliorated	47 (78.3%)	87 (61.7%)	134 (66.7%)
	stationary	0	1 (0.7%)	1 (0.5%)
	aggravated	0	4 (2.8%)	4 (2.0%)
	deceased	5 (8.3%)	7 (5.0%)	12 (6.0%)
Reinterventions		6 (10.5%)	8 (6.3%)	14 (7.6%)	OR=1.75 [0.58, 5.30] (p=0.370)
Venous resection		38 (61.3%)	0	38 (17.7%)	OR=482.43 [28.69, 8 111.03] (p<0.001)
Arterial resection		26 (41.9%)	0	26 (12.1%)	OR=222.89 [13.27, 3 743.21] (p<0.001)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.3.5 Reinterventions

Reinterventions were not significantly correlated to age (p=0.923), gender (p=0.404), vascular operation (p=0.575) or living status at 1-Oct-2019 (p=0.410).

Figure 6: Sex distribution by reinterventions.

Table 4: Demographic parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Age (years)	μ ±SD	61.72 ±11.4	62.91 ±9.71	62.83 ±9.51	MW: p=0.923
	M (min:max)	63.36 (40.28:75.93)	63.85 (21.94:87.33)	63.25 (21.94:87.33)
Sex	F	4 (28.6%)	78 (42.4%)	82 (41.4%)	OR=0.54 [0.16, 1.80] (p=0.404)
	M	10 (71.4%)	106 (57.6%)	116 (58.6%)
Alive at 1-Oct-2019		4 (28.6%)	75 (40.8%)	79 (39.9%)	OR=1.72 [0.52, 5.69] (p=0.413)
State at discharge	cured	3 (23.1%)	46 (26.0%)	49 (25.8%)	V=0.33 (p<0.001)
	ameliorated	6 (46.2%)	121 (68.4%)	127 (66.8%)
	stationary	0	1 (0.6%)	1 (0.5%)
	aggravated	0	4 (2.3%)	4 (2.1%)
	deceased	4 (30.8%)	5 (2.8%)	9 (4.7%)
Vascular operation		6 (42.9%)	51 (30.0%)	57 (31.0%)	OR=1.75 [0.58, 5.30] (p=0.370)
Venous resection		3 (21.4%)	32 (17.4%)	35 (17.7%)	OR=1.30 [0.34, 4.91] (p=0.717)
Arterial resection		3 (21.4%)	21 (11.4%)	24 (12.1%)	OR=2.12 [0.55, 8.21] (p=0.385)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.3.6 Laboratory

Laboratory values were highly skewed, therforee their medians may be better represetation of their distributions. These are presented below. They were not significantly correlated to any of the main outcome.

Table 5: Laboratory parameters of the sample.

Variable	Details	Total
N=		231
CA 19-9 (ng/mL)	μ ±SD	205.61 ±598.7
	M (min:max)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	10.55 ±23.0
	M (min:max)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	102.23 ±198.5
	M (min:max)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

Figure 7: Laboratory parameters.

2.3.6.1 by reinterventions

Table 6: Laboratory parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
CA 19-9 (ng/mL)	μ ±SD	158.32 ±171.1	147.39 ±167.6	205.61 ±598.7	MW: p=0.848
	M (min:max)	133.6 (1:400)	61.45 (1:741.3)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	5.55 ±4.88	11.65 ±24.8	10.55 ±23.0	MW: p>0.999
	M (min:max)	5.55 (2.1:9)	5.1 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		135.80 ±228.8	102.23 ±198.5
	M (min:max)		5.5 (1.9:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 8: Laboratory parameters, by reinterventions.

2.3.6.2 by Vascular operations

Table 7: Laboratory parameters of the sample, by vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
CA 19-9 (ng/mL)	μ ±SD	166.93 ±157.3	237.75 ±725.6	205.61 ±598.7	MW: p=0.835
	M (min:max)	154.25 (1:400)	61.45 (1:5610)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	7.05 ±4.37	6.29 ±6.99	10.55 ±23.0	MW: p=0.394
	M (min:max)	7.2 (1.9:11.9)	3.5 (0.9:31.8)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		135.68 ±228.9	102.23 ±198.5
	M (min:max)		5.5 (1.53:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 9: Laboratory parameters, by vascular operation.

2.3.6.3 by living status at Oct 1, 2019

Table 7: Laboratory parameters of the sample, by vascular operations.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
CA 19-9 (ng/mL)	μ ±SD	271.32 ±747.2	97.39 ±129.7	205.61 ±598.7	MW: p=0.075
	M (min:max)	119.05 (1:5610)	38.2 (1:400)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	7.71 ±7.85	14.11 ±33.8	10.55 ±23.0	MW: p=0.479
	M (min:max)	5.3 (1.6:31.8)	3.6 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	202.75 ±279.0	1.71 ±0.262	102.23 ±198.5	MW: p=0.333
	M (min:max)	202.75 (5.5:400)	1.71 (1.53:1.9)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 10: Laboratory parameters, by living status at Oct 1, 2019.

2.3.7 Toxics

Only 19% of the patients were somkers, 23% consumed alcohol and none were exposed to nistrosamines. Most patients denied exposure to any toxics. None of these variables were significantly correlated to any of the main outcome.

Figure 11: Distribution of patients with any of the listed Toxics.

Table 8: Distribution of patients with any of the listed Toxics.

Variable	Total
N=	231
None / deny	141 (61.0%)
Alcohol	53 (22.9%)
Smoking	44 (19.0%)
Nitrosamines	0
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.3.7.1 by reinterventions

Table 9: Distribution of patients with any of the listed Toxics, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
None / deny		8 (57.1%)	116 (63.0%)	124 (62.6%)	OR=0.78 [0.26, 2.35] (p=0.776)
Alcohol		5 (35.7%)	39 (21.2%)	44 (22.2%)	OR=2.07 [0.65, 6.52] (p=0.200)
Smoking		5 (35.7%)	32 (17.4%)	37 (18.7%)	OR=2.64 [0.83, 8.40] (p=0.145)
Nitrosamines		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 12: Distribution of patients with any of the listed Toxics, by Reinterventions status.

2.3.7.2 by Vascular operations

Table 10: Distribution of patients with any of the listed Toxics, by Vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
None / deny		38 (61.3%)	95 (62.1%)	133 (61.9%)	OR=0.97 [0.53, 1.77] (p>0.999)
Alcohol		13 (21.0%)	36 (23.5%)	49 (22.8%)	OR=0.86 [0.42, 1.77] (p=0.724)
Smoking		12 (19.4%)	29 (19.0%)	41 (19.1%)	OR=1.03 [0.49, 2.17] (p>0.999)
Nitrosamines		0	0	0	OR=2.46 [0.05, 125.15] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 13: Distribution of patients with any of the listed Toxics, by Vascular operation status.

2.3.7.3 by living status at Oct 1, 2019

Table 11: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
None / deny		82 (59.0%)	59 (64.1%)	141 (61.0%)	OR=0.80 [0.47, 1.39] (p=0.491)
Alcohol		34 (24.5%)	19 (20.7%)	53 (22.9%)	OR=1.24 [0.66, 2.35] (p=0.527)
Smoking		29 (20.9%)	15 (16.3%)	44 (19.0%)	OR=1.35 [0.68, 2.69] (p=0.494)
Nitrosamines		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 14: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

2.3.8 Imaging: Veins invasion

Veins invasion was observed most often by abdominal CT (4.3%) or echoendoscopy (1.7%). Ultrasound and MRI were even less effective.

Among those in who had vascular operations, 8 (10.3%) had veins invasion visible on abdominal CT compared to 2 (1.3%) among those who did not have any vascular operations. This relation was statistically significant (OR=8.63, p=0.003). All other correlations to the main outcome variables were not statisitcally significant.

Figure 15: Distribution of patients with any of the listed Imaging: Veins invasion.

Table 12: Distribution of patients with any of the listed Imaging: Veins invasion.

Variable	Total
N=	231
Ultrasound: Veins invasion	3 (1.3%)
Abdominal CT: Veins invasion	10 (4.3%)
MRI: Veins invasion	1 (0.4%)
Echoendoscopy: Veins invasion	4 (1.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.3.8.1 by reinterventions

Table 13: Distribution of patients with any of the listed Imaging: Veins invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Veins invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Abdominal CT: Veins invasion		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
MRI: Veins invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Echoendoscopy: Veins invasion		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 16: Distribution of patients with any of the listed Imaging: Veins invasion, by Reinterventions status.

2.3.8.2 by Vascular operations

Table 14: Distribution of patients with any of the listed Imaging: Veins invasion, by Vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
Ultrasound: Veins invasion		0	3 (2.0%)	3 (1.4%)	OR=0.34 [0.02, 6.76] (p=0.559)
Abdominal CT: Veins invasion		7 (11.3%)	2 (1.3%)	9 (4.2%)	OR=9.61 [1.94, 47.67] (p=0.003)
MRI: Veins invasion		0	1 (0.7%)	1 (0.5%)	OR=0.81 [0.03, 20.24] (p>0.999)
Echoendoscopy: Veins invasion		2 (3.2%)	2 (1.3%)	4 (1.9%)	OR=2.52 [0.35, 18.28] (p=0.581)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 17: Distribution of patients with any of the listed Imaging: Veins invasion, by Vascular operation status.

2.3.8.3 by living status at Oct 1, 2019

Table 15: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Veins invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
Abdominal CT: Veins invasion		6 (4.3%)	4 (4.3%)	10 (4.3%)	OR=0.99 [0.27, 3.62] (p>0.999)
MRI: Veins invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Echoendoscopy: Veins invasion		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 18: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

2.3.9 Imaging: Arteries invasion

Arteries invasion was observed most often by abdominal CT or echoendoscopy (1.3% each). Ultrasound and MRI were even less effective. None were significatly correlated to the main outcome variables.

Figure 19: Distribution of patients with any of the listed Imaging: Arteries invasion.

Table 16: Distribution of patients with any of the listed Imaging: Arteries invasion.

Variable	Total
N=	231
Ultrasound: Arteries invasion	1 (0.4%)
Abdominal CT: Arteries invasion	3 (1.3%)
MRI: Arteries invasion	0
Echoendoscopy: Arteries invasion	3 (1.3%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.3.9.1 by reinterventions

Table 17: Distribution of patients with any of the listed Imaging: Arteries invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Arteries invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Abdominal CT: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Echoendoscopy: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 20: Distribution of patients with any of the listed Imaging: Arteries invasion, by Reinterventions status.

2.3.9.2 by Vascular operation

Table 18: Distribution of patients with any of the listed Imaging: Arteries invasion, by Vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
Ultrasound: Arteries invasion		0	1 (0.7%)	1 (0.5%)	OR=0.81 [0.03, 20.24] (p>0.999)
Abdominal CT: Arteries invasion		2 (3.2%)	1 (0.7%)	3 (1.4%)	OR=5.07 [0.45, 56.92] (p=0.200)
MRI: Arteries invasion		0	0	0	OR=2.46 [0.05, 125.15] (p>0.999)
Echoendoscopy: Arteries invasion		1 (1.6%)	1 (0.7%)	2 (0.9%)	OR=2.49 [0.15, 40.48] (p=0.495)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 21: Distribution of patients with any of the listed Imaging: Arteries invasion, by Vascular operation status.

2.3.9.3 by living status at Oct 1, 2019

Table 19: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Arteries invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Abdominal CT: Arteries invasion		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Echoendoscopy: Arteries invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 22: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

2.3.10 Vascular invasion

Approximatively 86% of the patients had no vascular invason. Among those who had any, the portal and superior mesenteric veins were most often affected. In those cases, vascular operations had significantly higher odds of being performed (portal vein: OR=11.90, p<0.001; superior mesenteric vein: OR=19.83, p<0.001). Patients with no vascular involvement had significantly lower odds of being dead at Oct-1-2019 (OR=0.35, p=0.021).

Figure 23: Distribution of patients with any of the listed Vascular invasion.

Table 20: Distribution of patients with any of the listed Vascular invasion.

Variable	Total
N=	231
Portal vein	18 (7.8%)
Superior mesenteric vein	10 (4.3%)
Confluent	3 (1.3%)
Celiac trunk	0
Superior mesenteric artery	4 (1.7%)
Common hepatic artery	0
Splenic artery	0
Other	1 (0.4%)
No vascular invasion	198 (85.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.3.10.1 by reinterventions

Table 21: Distribution of patients with any of the listed Vascular invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Portal vein		1 (7.1%)	17 (9.2%)	18 (9.1%)	OR=0.76 [0.09, 6.14] (p>0.999)
Superior mesenteric vein		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
Confluent		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Celiac trunk		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Superior mesenteric artery		0	4 (2.2%)	4 (2.0%)	OR=1.38 [0.07, 26.97] (p>0.999)
Common hepatic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Splenic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Other		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
No vascular invasion		12 (85.7%)	153 (83.2%)	165 (83.3%)	OR=1.22 [0.26, 5.70] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 24: Distribution of patients with any of the listed Vascular invasion, by Reinterventions status.

2.3.10.2 by Vascular operation

Table 22: Distribution of patients with any of the listed Vascular invasion, by Vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
Portal vein		15 (24.2%)	3 (2.0%)	18 (8.4%)	OR=15.96 [4.43, 57.52] (p<0.001)
Superior mesenteric vein		9 (14.5%)	1 (0.7%)	10 (4.7%)	OR=25.81 [3.19, 208.58] (p<0.001)
Confluent		1 (1.6%)	2 (1.3%)	3 (1.4%)	OR=1.24 [0.11, 13.90] (p>0.999)
Celiac trunk		0	0	0	OR=2.46 [0.05, 125.15] (p>0.999)
Superior mesenteric artery		1 (1.6%)	2 (1.3%)	3 (1.4%)	OR=1.24 [0.11, 13.90] (p>0.999)
Common hepatic artery		0	0	0	OR=2.46 [0.05, 125.15] (p>0.999)
Splenic artery		0	0	0	OR=2.46 [0.05, 125.15] (p>0.999)
Other		0	1 (0.7%)	1 (0.5%)	OR=0.81 [0.03, 20.24] (p>0.999)
No vascular invasion		37 (59.7%)	146 (95.4%)	183 (85.1%)	OR=0.07 [0.03, 0.18] (p<0.001)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 25: Distribution of patients with any of the listed Vascular invasion, by Vascular operation status.

2.3.10.3 by living status at Oct 1, 2019

Table 23: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Portal vein		13 (9.4%)	5 (5.4%)	18 (7.8%)	OR=1.80 [0.62, 5.22] (p=0.325)
Superior mesenteric vein		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Confluent		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Celiac trunk		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Superior mesenteric artery		4 (2.9%)	0	4 (1.7%)	OR=6.14 [0.33, 115.48] (p=0.153)
Common hepatic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Splenic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Other		0	1 (1.1%)	1 (0.4%)	OR=0.22 [0.01, 5.43] (p=0.398)
No vascular invasion		113 (81.3%)	85 (92.4%)	198 (85.7%)	OR=0.36 [0.15, 0.86] (p=0.021)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 26: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

2.3.11 Complications

Gastric staxis (10.4%) and suppuration (9.5%) were the most common complications. Pancreatic fistula, Digestive fistula, Pancreatitis, Suppuration, Intraperitoneala hemorrhage and Cardiovascular were significantly associated to higher odds of reinterventions. None were significantly associated to mortality or vascular operations.

Figure 27: Distribution of patients with any of the listed Complications.

Table 24: Distribution of patients with any of the listed Complications.

Variable	Total
N=	231
Pancreatic fistula	16 (6.9%)
Bile ducts fistula	7 (3.0%)
Digestive fistula	3 (1.3%)
Hemorrhage	11 (4.8%)
Gastric stasis	24 (10.4%)
Pancreatitis	3 (1.3%)
Peritonits	1 (0.4%)
Suppuration	22 (9.5%)
Intraperitoneala hemorrhage	2 (0.9%)
Septic shock	1 (0.4%)
Pulmonar	8 (3.5%)
Cardiovascular	10 (4.3%)
Hepatic	4 (1.7%)
Other	22 (9.5%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.3.11.1 by reinterventions

Table 25: Distribution of patients with any of the listed Complications, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Pancreatic fistula		4 (28.6%)	11 (6.0%)	15 (7.6%)	OR=6.29 [1.70, 23.31] (p=0.014)
Bile ducts fistula		2 (14.3%)	5 (2.7%)	7 (3.5%)	OR=5.97 [1.05, 34.02] (p=0.080)
Digestive fistula		3 (21.4%)	0	3 (1.5%)	OR=112.30 [5.47, 2 306.96] (p<0.001)
Hemorrhage		2 (14.3%)	9 (4.9%)	11 (5.6%)	OR=3.24 [0.63, 16.71] (p=0.177)
Gastric stasis		2 (14.3%)	20 (10.9%)	22 (11.1%)	OR=1.37 [0.29, 6.55] (p=0.658)
Pancreatitis		2 (14.3%)	1 (0.5%)	3 (1.5%)	OR=30.50 [2.58, 360.76] (p=0.013)
Peritonits		1 (7.1%)	0	1 (0.5%)	OR=41.00 [1.59, 1 055.25] (p=0.071)
Suppuration		4 (28.6%)	16 (8.7%)	20 (10.1%)	OR=4.20 [1.18, 14.92] (p=0.039)
Intraperitoneala hemorrhage		2 (14.3%)	0	2 (1.0%)	OR=73.80 [3.36, 1 621.79] (p=0.005)
Septic shock		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Pulmonar		2 (14.3%)	6 (3.3%)	8 (4.0%)	OR=4.94 [0.90, 27.17] (p=0.102)
Cardiovascular		4 (28.6%)	6 (3.3%)	10 (5.1%)	OR=11.87 [2.88, 48.92] (p=0.003)
Hepatic		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
Other		5 (35.7%)	14 (7.6%)	19 (9.6%)	OR=6.75 [1.99, 22.88] (p=0.005)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 28: Distribution of patients with any of the listed Complications, by Reinterventions status.

2.3.11.2 by Vascular operation

Table 26: Distribution of patients with any of the listed Complications, by Vascular operations.

Variable	Details	yes	no	Total	Statistics
Vascular operation		62 (28.8%)	153 (71.2%)	215
Pancreatic fistula		9 (14.5%)	7 (4.6%)	16 (7.4%)	OR=3.54 [1.26, 9.99] (p=0.019)
Bile ducts fistula		1 (1.6%)	6 (3.9%)	7 (3.3%)	OR=0.40 [0.05, 3.41] (p=0.676)
Digestive fistula		1 (1.6%)	2 (1.3%)	3 (1.4%)	OR=1.24 [0.11, 13.90] (p>0.999)
Hemorrhage		3 (4.8%)	8 (5.2%)	11 (5.1%)	OR=0.92 [0.24, 3.59] (p>0.999)
Gastric stasis		8 (12.9%)	14 (9.2%)	22 (10.2%)	OR=1.47 [0.58, 3.70] (p=0.458)
Pancreatitis		2 (3.2%)	1 (0.7%)	3 (1.4%)	OR=5.07 [0.45, 56.92] (p=0.200)
Peritonits		0	1 (0.7%)	1 (0.5%)	OR=0.81 [0.03, 20.24] (p>0.999)
Suppuration		8 (12.9%)	12 (7.8%)	20 (9.3%)	OR=1.74 [0.67, 4.49] (p=0.300)
Intraperitoneala hemorrhage		1 (1.6%)	1 (0.7%)	2 (0.9%)	OR=2.49 [0.15, 40.48] (p=0.495)
Septic shock		0	1 (0.7%)	1 (0.5%)	OR=0.81 [0.03, 20.24] (p>0.999)
Pulmonar		4 (6.5%)	4 (2.6%)	8 (3.7%)	OR=2.57 [0.62, 10.61] (p=0.232)
Cardiovascular		3 (4.8%)	7 (4.6%)	10 (4.7%)	OR=1.06 [0.27, 4.24] (p>0.999)
Hepatic		1 (1.6%)	3 (2.0%)	4 (1.9%)	OR=0.82 [0.08, 8.04] (p>0.999)
Other		8 (12.9%)	13 (8.5%)	21 (9.8%)	OR=1.60 [0.63, 4.06] (p=0.321)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 29: Distribution of patients with any of the listed Complications, by Vascular operation status.

2.3.11.3 by living status at Oct 1, 2019

Table 27: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Pancreatic fistula		9 (6.5%)	7 (7.6%)	16 (6.9%)	OR=0.84 [0.30, 2.34] (p=0.794)
Bile ducts fistula		6 (4.3%)	1 (1.1%)	7 (3.0%)	OR=4.11 [0.49, 34.67] (p=0.248)
Digestive fistula		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Hemorrhage		8 (5.8%)	3 (3.3%)	11 (4.8%)	OR=1.81 [0.47, 7.02] (p=0.533)
Gastric stasis		14 (10.1%)	10 (10.9%)	24 (10.4%)	OR=0.92 [0.39, 2.17] (p=0.830)
Pancreatitis		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
Peritonits		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Suppuration		14 (10.1%)	8 (8.7%)	22 (9.5%)	OR=1.18 [0.47, 2.93] (p=0.821)
Intraperitoneala hemorrhage		2 (1.4%)	0	2 (0.9%)	OR=3.36 [0.16, 70.87] (p=0.519)
Septic shock		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Pulmonar		7 (5.0%)	1 (1.1%)	8 (3.5%)	OR=4.83 [0.58, 39.89] (p=0.150)
Cardiovascular		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Hepatic		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
Other		18 (12.9%)	4 (4.3%)	22 (9.5%)	OR=3.27 [1.07, 10.01] (p=0.038)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 30: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

2.4 Results for arteries

2.4.1 Arterial resection

Figure 31: Patients distribution by Arterial resection.

Table 28: Demographic parameters of the sample, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
Age (years)	μ ±SD	61.10 ±11.3	63.05 ±9.26	62.83 ±9.51	MW: p=0.388
	M (min:max)	63.62 (40.28:87.33)	63.25 (21.94:80.67)	63.25 (21.94:87.33)
Sex	F	9 (34.6%)	85 (41.5%)	94 (40.7%)	OR=0.75 [0.32, 1.76] (p=0.534)
	M	17 (65.4%)	120 (58.5%)	137 (59.3%)
Alive at 1-Oct-2019		16 (61.5%)	76 (37.1%)	92 (39.8%)	OR=0.37 [0.16, 0.85] (p=0.020)
State at discharge	cured	3 (11.5%)	50 (26.5%)	53 (24.7%)	V=0.14 (p=0.379)
	ameliorated	22 (84.6%)	123 (65.1%)	145 (67.4%)
	stationary	0	1 (0.5%)	1 (0.5%)
	aggravated	0	4 (2.1%)	4 (1.9%)
	deceased	1 (3.8%)	11 (5.8%)	12 (5.6%)
Reinterventions		3 (12.5%)	11 (6.3%)	14 (7.1%)	OR=2.12 [0.55, 8.21] (p=0.385)
Vascular operation		26 (100%)	36 (19.0%)	62 (28.8%)	OR=222.89 [13.27, 3 743.21] (p<0.001)
Venous resection		2 (7.7%)	36 (17.6%)	38 (16.5%)	OR=0.39 [0.09, 1.73] (p=0.268)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.4.2 Reinterventions

Reinterventions were not significantly correlated to age (p=0.923), gender (p=0.404), Arterial resection (p=0.575) or living status at 1-Oct-2019 (p=0.410).

Figure 6: Sex distribution by reinterventions.

Table 4: Demographic parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Age (years)	μ ±SD	61.72 ±11.4	62.91 ±9.71	62.83 ±9.51	MW: p=0.923
	M (min:max)	63.36 (40.28:75.93)	63.85 (21.94:87.33)	63.25 (21.94:87.33)
Sex	F	4 (28.6%)	78 (42.4%)	82 (41.4%)	OR=0.54 [0.16, 1.80] (p=0.404)
	M	10 (71.4%)	106 (57.6%)	116 (58.6%)
Alive at 1-Oct-2019		4 (28.6%)	75 (40.8%)	79 (39.9%)	OR=1.72 [0.52, 5.69] (p=0.413)
State at discharge	cured	3 (23.1%)	46 (26.0%)	49 (25.8%)	V=0.33 (p<0.001)
	ameliorated	6 (46.2%)	121 (68.4%)	127 (66.8%)
	stationary	0	1 (0.6%)	1 (0.5%)
	aggravated	0	4 (2.3%)	4 (2.1%)
	deceased	4 (30.8%)	5 (2.8%)	9 (4.7%)
Vascular operation		6 (42.9%)	51 (30.0%)	57 (31.0%)	OR=1.75 [0.58, 5.30] (p=0.370)
Venous resection		3 (21.4%)	32 (17.4%)	35 (17.7%)	OR=1.30 [0.34, 4.91] (p=0.717)
Arterial resection		3 (21.4%)	21 (11.4%)	24 (12.1%)	OR=2.12 [0.55, 8.21] (p=0.385)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.4.3 Laboratory

Laboratory values were highly skewed, therforee their medians may be better represetation of their distributions. These are presented below. They were not significantly correlated to any of the main outcome.

Table 5: Laboratory parameters of the sample.

Variable	Details	Total
N=		231
CA 19-9 (ng/mL)	μ ±SD	205.61 ±598.7
	M (min:max)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	10.55 ±23.0
	M (min:max)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	102.23 ±198.5
	M (min:max)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

Figure 7: Laboratory parameters.

2.4.3.1 by reinterventions

Table 6: Laboratory parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
CA 19-9 (ng/mL)	μ ±SD	158.32 ±171.1	147.39 ±167.6	205.61 ±598.7	MW: p=0.848
	M (min:max)	133.6 (1:400)	61.45 (1:741.3)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	5.55 ±4.88	11.65 ±24.8	10.55 ±23.0	MW: p>0.999
	M (min:max)	5.55 (2.1:9)	5.1 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		135.80 ±228.8	102.23 ±198.5
	M (min:max)		5.5 (1.9:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 8: Laboratory parameters, by reinterventions.

2.4.3.2 by Arterial resections

Table 29: Laboratory parameters of the sample, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
CA 19-9 (ng/mL)	μ ±SD	82.94 ±141.1	217.58 ±624.9	205.61 ±598.7	MW: p=0.134
	M (min:max)	24.75 (2:400)	66.05 (1:5610)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	7.05 ±4.37	11.16 ±24.9	10.55 ±23.0	MW: p=0.473
	M (min:max)	7.2 (1.9:11.9)	3.7 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		102.23 ±198.5	102.23 ±198.5
	M (min:max)		3.7 (1.53:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 32: Laboratory parameters, by Arterial resection.

2.4.3.3 by living status at Oct 1, 2019

Table 29: Laboratory parameters of the sample, by Arterial resections.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
CA 19-9 (ng/mL)	μ ±SD	271.32 ±747.2	97.39 ±129.7	205.61 ±598.7	MW: p=0.075
	M (min:max)	119.05 (1:5610)	38.2 (1:400)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	7.71 ±7.85	14.11 ±33.8	10.55 ±23.0	MW: p=0.479
	M (min:max)	5.3 (1.6:31.8)	3.6 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	202.75 ±279.0	1.71 ±0.262	102.23 ±198.5	MW: p=0.333
	M (min:max)	202.75 (5.5:400)	1.71 (1.53:1.9)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 10: Laboratory parameters, by living status at Oct 1, 2019.

2.4.4 Toxics

Only 19% of the patients were somkers, 23% consumed alcohol and none were exposed to nistrosamines. Most patients denied exposure to any toxics. None of these variables were significantly correlated to any of the main outcome.

Figure 11: Distribution of patients with any of the listed Toxics.

Table 8: Distribution of patients with any of the listed Toxics.

Variable	Total
N=	231
None / deny	141 (61.0%)
Alcohol	53 (22.9%)
Smoking	44 (19.0%)
Nitrosamines	0
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.4.1 by reinterventions

Table 9: Distribution of patients with any of the listed Toxics, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
None / deny		8 (57.1%)	116 (63.0%)	124 (62.6%)	OR=0.78 [0.26, 2.35] (p=0.776)
Alcohol		5 (35.7%)	39 (21.2%)	44 (22.2%)	OR=2.07 [0.65, 6.52] (p=0.200)
Smoking		5 (35.7%)	32 (17.4%)	37 (18.7%)	OR=2.64 [0.83, 8.40] (p=0.145)
Nitrosamines		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 12: Distribution of patients with any of the listed Toxics, by Reinterventions status.

2.4.4.2 by Arterial resections

Table 30: Distribution of patients with any of the listed Toxics, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
None / deny		16 (61.5%)	125 (61.0%)	141 (61.0%)	OR=1.02 [0.44, 2.37] (p>0.999)
Alcohol		7 (26.9%)	46 (22.4%)	53 (22.9%)	OR=1.27 [0.50, 3.22] (p=0.623)
Smoking		4 (15.4%)	40 (19.5%)	44 (19.0%)	OR=0.75 [0.24, 2.30] (p=0.793)
Nitrosamines		0	0	0	OR=7.75 [0.15, 399.03] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 33: Distribution of patients with any of the listed Toxics, by Arterial resection status.

2.4.4.3 by living status at Oct 1, 2019

Table 11: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
None / deny		82 (59.0%)	59 (64.1%)	141 (61.0%)	OR=0.80 [0.47, 1.39] (p=0.491)
Alcohol		34 (24.5%)	19 (20.7%)	53 (22.9%)	OR=1.24 [0.66, 2.35] (p=0.527)
Smoking		29 (20.9%)	15 (16.3%)	44 (19.0%)	OR=1.35 [0.68, 2.69] (p=0.494)
Nitrosamines		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 14: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

2.4.5 Imaging: Veins invasion

Veins invasion was observed most often by abdominal CT (4.3%) or echoendoscopy (1.7%). Ultrasound and MRI were even less effective.

Among those in who had Arterial resections, 8 (10.3%) had veins invasion visible on abdominal CT compared to 2 (1.3%) among those who did not have any Arterial resections. This relation was statistically significant (OR=8.63, p=0.003). All other correlations to the main outcome variables were not statisitcally significant.

Figure 15: Distribution of patients with any of the listed Imaging: Veins invasion.

Table 12: Distribution of patients with any of the listed Imaging: Veins invasion.

Variable	Total
N=	231
Ultrasound: Veins invasion	3 (1.3%)
Abdominal CT: Veins invasion	10 (4.3%)
MRI: Veins invasion	1 (0.4%)
Echoendoscopy: Veins invasion	4 (1.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.5.1 by reinterventions

Table 13: Distribution of patients with any of the listed Imaging: Veins invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Veins invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Abdominal CT: Veins invasion		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
MRI: Veins invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Echoendoscopy: Veins invasion		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 16: Distribution of patients with any of the listed Imaging: Veins invasion, by Reinterventions status.

2.4.5.2 by Arterial resections

Table 31: Distribution of patients with any of the listed Imaging: Veins invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
Ultrasound: Veins invasion		0	3 (1.5%)	3 (1.3%)	OR=1.09 [0.05, 21.72] (p>0.999)
Abdominal CT: Veins invasion		1 (3.8%)	9 (4.4%)	10 (4.3%)	OR=0.87 [0.11, 7.17] (p>0.999)
MRI: Veins invasion		0	1 (0.5%)	1 (0.4%)	OR=2.57 [0.10, 64.77] (p>0.999)
Echoendoscopy: Veins invasion		0	4 (2.0%)	4 (1.7%)	OR=0.84 [0.04, 16.14] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 34: Distribution of patients with any of the listed Imaging: Veins invasion, by Arterial resection status.

2.4.5.3 by living status at Oct 1, 2019

Table 15: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Veins invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
Abdominal CT: Veins invasion		6 (4.3%)	4 (4.3%)	10 (4.3%)	OR=0.99 [0.27, 3.62] (p>0.999)
MRI: Veins invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Echoendoscopy: Veins invasion		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 18: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

2.4.6 Imaging: Arteries invasion

Arteries invasion was observed most often by abdominal CT or echoendoscopy (1.3% each). Ultrasound and MRI were even less effective. None were significatly correlated to the main outcome variables.

Figure 19: Distribution of patients with any of the listed Imaging: Arteries invasion.

Table 16: Distribution of patients with any of the listed Imaging: Arteries invasion.

Variable	Total
N=	231
Ultrasound: Arteries invasion	1 (0.4%)
Abdominal CT: Arteries invasion	3 (1.3%)
MRI: Arteries invasion	0
Echoendoscopy: Arteries invasion	3 (1.3%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.6.1 by reinterventions

Table 17: Distribution of patients with any of the listed Imaging: Arteries invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Arteries invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Abdominal CT: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Echoendoscopy: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 20: Distribution of patients with any of the listed Imaging: Arteries invasion, by Reinterventions status.

2.4.6.2 by Arterial resection

Table 32: Distribution of patients with any of the listed Imaging: Arteries invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
Ultrasound: Arteries invasion		0	1 (0.5%)	1 (0.4%)	OR=2.57 [0.10, 64.77] (p>0.999)
Abdominal CT: Arteries invasion		0	3 (1.5%)	3 (1.3%)	OR=1.09 [0.05, 21.72] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=7.75 [0.15, 399.03] (p>0.999)
Echoendoscopy: Arteries invasion		1 (3.8%)	2 (1.0%)	3 (1.3%)	OR=4.06 [0.36, 46.40] (p=0.302)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 35: Distribution of patients with any of the listed Imaging: Arteries invasion, by Arterial resection status.

2.4.6.3 by living status at Oct 1, 2019

Table 19: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Arteries invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Abdominal CT: Arteries invasion		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Echoendoscopy: Arteries invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 22: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

2.4.7 Vascular invasion

Approximatively 86% of the patients had no vascular invason. Among those who had any, the portal and superior mesenteric veins were most often affected. In those cases, Arterial resections had significantly higher odds of being performed (portal vein: OR=11.90, p<0.001; superior mesenteric vein: OR=19.83, p<0.001). Patients with no vascular inARlvement had significantly lower odds of being dead at Oct-1-2019 (OR=0.35, p=0.021).

Figure 23: Distribution of patients with any of the listed Vascular invasion.

Table 20: Distribution of patients with any of the listed Vascular invasion.

Variable	Total
N=	231
Portal vein	18 (7.8%)
Superior mesenteric vein	10 (4.3%)
Confluent	3 (1.3%)
Celiac trunk	0
Superior mesenteric artery	4 (1.7%)
Common hepatic artery	0
Splenic artery	0
Other	1 (0.4%)
No vascular invasion	198 (85.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.7.1 by reinterventions

Table 21: Distribution of patients with any of the listed Vascular invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Portal vein		1 (7.1%)	17 (9.2%)	18 (9.1%)	OR=0.76 [0.09, 6.14] (p>0.999)
Superior mesenteric vein		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
Confluent		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Celiac trunk		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Superior mesenteric artery		0	4 (2.2%)	4 (2.0%)	OR=1.38 [0.07, 26.97] (p>0.999)
Common hepatic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Splenic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Other		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
No vascular invasion		12 (85.7%)	153 (83.2%)	165 (83.3%)	OR=1.22 [0.26, 5.70] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 24: Distribution of patients with any of the listed Vascular invasion, by Reinterventions status.

2.4.7.2 by Arterial resection

Table 33: Distribution of patients with any of the listed Vascular invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
Portal vein		1 (3.8%)	17 (8.3%)	18 (7.8%)	OR=0.44 [0.06, 3.47] (p=0.701)
Superior mesenteric vein		0	10 (4.9%)	10 (4.3%)	OR=0.35 [0.02, 6.17] (p=0.608)
Confluent		0	3 (1.5%)	3 (1.3%)	OR=1.09 [0.05, 21.72] (p>0.999)
Celiac trunk		0	0	0	OR=7.75 [0.15, 399.03] (p>0.999)
Superior mesenteric artery		1 (3.8%)	3 (1.5%)	4 (1.7%)	OR=2.69 [0.27, 26.89] (p=0.382)
Common hepatic artery		0	0	0	OR=7.75 [0.15, 399.03] (p>0.999)
Splenic artery		0	0	0	OR=7.75 [0.15, 399.03] (p>0.999)
Other		0	1 (0.5%)	1 (0.4%)	OR=2.57 [0.10, 64.77] (p>0.999)
No vascular invasion		24 (92.3%)	174 (84.9%)	198 (85.7%)	OR=2.14 [0.48, 9.51] (p=0.389)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 36: Distribution of patients with any of the listed Vascular invasion, by Arterial resection status.

2.4.7.3 by living status at Oct 1, 2019

Table 23: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Portal vein		13 (9.4%)	5 (5.4%)	18 (7.8%)	OR=1.80 [0.62, 5.22] (p=0.325)
Superior mesenteric vein		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Confluent		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Celiac trunk		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Superior mesenteric artery		4 (2.9%)	0	4 (1.7%)	OR=6.14 [0.33, 115.48] (p=0.153)
Common hepatic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Splenic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Other		0	1 (1.1%)	1 (0.4%)	OR=0.22 [0.01, 5.43] (p=0.398)
No vascular invasion		113 (81.3%)	85 (92.4%)	198 (85.7%)	OR=0.36 [0.15, 0.86] (p=0.021)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 26: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

2.4.8 Complications

Gastric staxis (10.4%) and suppuration (9.5%) were the most common complications. Pancreatic fistula, Digestive fistula, Pancreatitis, Suppuration, Intraperitoneala hemorrhage and Cardiovascular were significantly associated to higher odds of reinterventions. None were significantly associated to mortality or Arterial resections.

Figure 27: Distribution of patients with any of the listed Complications.

Table 24: Distribution of patients with any of the listed Complications.

Variable	Total
N=	231
Pancreatic fistula	16 (6.9%)
Bile ducts fistula	7 (3.0%)
Digestive fistula	3 (1.3%)
Hemorrhage	11 (4.8%)
Gastric stasis	24 (10.4%)
Pancreatitis	3 (1.3%)
Peritonits	1 (0.4%)
Suppuration	22 (9.5%)
Intraperitoneala hemorrhage	2 (0.9%)
Septic shock	1 (0.4%)
Pulmonar	8 (3.5%)
Cardiovascular	10 (4.3%)
Hepatic	4 (1.7%)
Other	22 (9.5%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.8.1 by reinterventions

Table 25: Distribution of patients with any of the listed Complications, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Pancreatic fistula		4 (28.6%)	11 (6.0%)	15 (7.6%)	OR=6.29 [1.70, 23.31] (p=0.014)
Bile ducts fistula		2 (14.3%)	5 (2.7%)	7 (3.5%)	OR=5.97 [1.05, 34.02] (p=0.080)
Digestive fistula		3 (21.4%)	0	3 (1.5%)	OR=112.30 [5.47, 2 306.96] (p<0.001)
Hemorrhage		2 (14.3%)	9 (4.9%)	11 (5.6%)	OR=3.24 [0.63, 16.71] (p=0.177)
Gastric stasis		2 (14.3%)	20 (10.9%)	22 (11.1%)	OR=1.37 [0.29, 6.55] (p=0.658)
Pancreatitis		2 (14.3%)	1 (0.5%)	3 (1.5%)	OR=30.50 [2.58, 360.76] (p=0.013)
Peritonits		1 (7.1%)	0	1 (0.5%)	OR=41.00 [1.59, 1 055.25] (p=0.071)
Suppuration		4 (28.6%)	16 (8.7%)	20 (10.1%)	OR=4.20 [1.18, 14.92] (p=0.039)
Intraperitoneala hemorrhage		2 (14.3%)	0	2 (1.0%)	OR=73.80 [3.36, 1 621.79] (p=0.005)
Septic shock		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Pulmonar		2 (14.3%)	6 (3.3%)	8 (4.0%)	OR=4.94 [0.90, 27.17] (p=0.102)
Cardiovascular		4 (28.6%)	6 (3.3%)	10 (5.1%)	OR=11.87 [2.88, 48.92] (p=0.003)
Hepatic		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
Other		5 (35.7%)	14 (7.6%)	19 (9.6%)	OR=6.75 [1.99, 22.88] (p=0.005)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 28: Distribution of patients with any of the listed Complications, by Reinterventions status.

2.4.8.2 by Arterial resection

Table 34: Distribution of patients with any of the listed Complications, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Arterial resection		26 (11.3%)	205 (88.7%)	231
Pancreatic fistula		6 (23.1%)	10 (4.9%)	16 (6.9%)	OR=5.85 [1.92, 17.78] (p=0.004)
Bile ducts fistula		1 (3.8%)	6 (2.9%)	7 (3.0%)	OR=1.33 [0.15, 11.47] (p=0.572)
Digestive fistula		0	3 (1.5%)	3 (1.3%)	OR=1.09 [0.05, 21.72] (p>0.999)
Hemorrhage		0	11 (5.4%)	11 (4.8%)	OR=0.32 [0.02, 5.57] (p=0.618)
Gastric stasis		7 (26.9%)	17 (8.3%)	24 (10.4%)	OR=4.07 [1.50, 11.06] (p=0.009)
Pancreatitis		1 (3.8%)	2 (1.0%)	3 (1.3%)	OR=4.06 [0.36, 46.40] (p=0.302)
Peritonits		0	1 (0.5%)	1 (0.4%)	OR=2.57 [0.10, 64.77] (p>0.999)
Suppuration		6 (23.1%)	16 (7.8%)	22 (9.5%)	OR=3.54 [1.25, 10.08] (p=0.024)
Intraperitoneala hemorrhage		0	2 (1.0%)	2 (0.9%)	OR=1.54 [0.07, 32.86] (p>0.999)
Septic shock		0	1 (0.5%)	1 (0.4%)	OR=2.57 [0.10, 64.77] (p>0.999)
Pulmonar		2 (7.7%)	6 (2.9%)	8 (3.5%)	OR=2.76 [0.53, 14.47] (p=0.223)
Cardiovascular		2 (7.7%)	8 (3.9%)	10 (4.3%)	OR=2.05 [0.41, 10.23] (p=0.313)
Hepatic		0	4 (2.0%)	4 (1.7%)	OR=0.84 [0.04, 16.14] (p>0.999)
Other		1 (3.8%)	21 (10.2%)	22 (9.5%)	OR=0.35 [0.05, 2.72] (p=0.482)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 37: Distribution of patients with any of the listed Complications, by Arterial resection status.

2.4.8.3 by living status at Oct 1, 2019

Table 27: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Pancreatic fistula		9 (6.5%)	7 (7.6%)	16 (6.9%)	OR=0.84 [0.30, 2.34] (p=0.794)
Bile ducts fistula		6 (4.3%)	1 (1.1%)	7 (3.0%)	OR=4.11 [0.49, 34.67] (p=0.248)
Digestive fistula		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Hemorrhage		8 (5.8%)	3 (3.3%)	11 (4.8%)	OR=1.81 [0.47, 7.02] (p=0.533)
Gastric stasis		14 (10.1%)	10 (10.9%)	24 (10.4%)	OR=0.92 [0.39, 2.17] (p=0.830)
Pancreatitis		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
Peritonits		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Suppuration		14 (10.1%)	8 (8.7%)	22 (9.5%)	OR=1.18 [0.47, 2.93] (p=0.821)
Intraperitoneala hemorrhage		2 (1.4%)	0	2 (0.9%)	OR=3.36 [0.16, 70.87] (p=0.519)
Septic shock		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Pulmonar		7 (5.0%)	1 (1.1%)	8 (3.5%)	OR=4.83 [0.58, 39.89] (p=0.150)
Cardiovascular		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Hepatic		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
Other		18 (12.9%)	4 (4.3%)	22 (9.5%)	OR=3.27 [1.07, 10.01] (p=0.038)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 30: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

2.4.9 Venous resection

Figure 38: Patients distribution by Venous resection.

Table 35: Demographic parameters of the sample, by Venous resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
Age (years)	μ ±SD	63.14 ±9.06	62.78 ±9.61	62.83 ±9.51	MW: p=0.785
	M (min:max)	63.02 (45.65:87.33)	63.62 (21.94:82.92)	63.25 (21.94:87.33)
Sex	F	13 (34.2%)	81 (42.0%)	94 (40.7%)	OR=0.72 [0.35, 1.49] (p=0.470)
	M	25 (65.8%)	112 (58.0%)	137 (59.3%)
Alive at 1-Oct-2019		11 (28.9%)	81 (42.0%)	92 (39.8%)	OR=1.78 [0.83, 3.78] (p=0.150)
State at discharge	cured	5 (13.9%)	48 (26.8%)	53 (24.7%)	V=0.16 (p=0.217)
	ameliorated	27 (75.0%)	118 (65.9%)	145 (67.4%)
	stationary	0	1 (0.6%)	1 (0.5%)
	aggravated	0	4 (2.2%)	4 (1.9%)
	deceased	4 (11.1%)	8 (4.5%)	12 (5.6%)
Reinterventions		3 (8.6%)	11 (6.7%)	14 (7.1%)	OR=1.30 [0.34, 4.91] (p=0.717)
Vascular operation		38 (100%)	24 (13.6%)	62 (28.8%)	OR=482.43 [28.69, 8 111.03] (p<0.001)
Arterial resection		2 (5.3%)	24 (12.4%)	26 (11.3%)	OR=0.39 [0.09, 1.73] (p=0.268)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.4.10 Reinterventions

Reinterventions were not significantly correlated to age (p=0.923), gender (p=0.404), Venous resection (p=0.575) or living status at 1-Oct-2019 (p=0.410).

Figure 6: Sex distribution by reinterventions.

Table 4: Demographic parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Age (years)	μ ±SD	61.72 ±11.4	62.91 ±9.71	62.83 ±9.51	MW: p=0.923
	M (min:max)	63.36 (40.28:75.93)	63.85 (21.94:87.33)	63.25 (21.94:87.33)
Sex	F	4 (28.6%)	78 (42.4%)	82 (41.4%)	OR=0.54 [0.16, 1.80] (p=0.404)
	M	10 (71.4%)	106 (57.6%)	116 (58.6%)
Alive at 1-Oct-2019		4 (28.6%)	75 (40.8%)	79 (39.9%)	OR=1.72 [0.52, 5.69] (p=0.413)
State at discharge	cured	3 (23.1%)	46 (26.0%)	49 (25.8%)	V=0.33 (p<0.001)
	ameliorated	6 (46.2%)	121 (68.4%)	127 (66.8%)
	stationary	0	1 (0.6%)	1 (0.5%)
	aggravated	0	4 (2.3%)	4 (2.1%)
	deceased	4 (30.8%)	5 (2.8%)	9 (4.7%)
Vascular operation		6 (42.9%)	51 (30.0%)	57 (31.0%)	OR=1.75 [0.58, 5.30] (p=0.370)
Venous resection		3 (21.4%)	32 (17.4%)	35 (17.7%)	OR=1.30 [0.34, 4.91] (p=0.717)
Arterial resection		3 (21.4%)	21 (11.4%)	24 (12.1%)	OR=2.12 [0.55, 8.21] (p=0.385)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

2.4.11 Laboratory

Laboratory values were highly skewed, therforee their medians may be better represetation of their distributions. These are presented below. They were not significantly correlated to any of the main outcome.

Table 5: Laboratory parameters of the sample.

Variable	Details	Total
N=		231
CA 19-9 (ng/mL)	μ ±SD	205.61 ±598.7
	M (min:max)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	10.55 ±23.0
	M (min:max)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	102.23 ±198.5
	M (min:max)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

Figure 7: Laboratory parameters.

2.4.11.1 by reinterventions

Table 6: Laboratory parameters of the sample, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
CA 19-9 (ng/mL)	μ ±SD	158.32 ±171.1	147.39 ±167.6	205.61 ±598.7	MW: p=0.848
	M (min:max)	133.6 (1:400)	61.45 (1:741.3)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	5.55 ±4.88	11.65 ±24.8	10.55 ±23.0	MW: p>0.999
	M (min:max)	5.55 (2.1:9)	5.1 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		135.80 ±228.8	102.23 ±198.5
	M (min:max)		5.5 (1.9:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 8: Laboratory parameters, by reinterventions.

2.4.11.2 by Venous resections

Table 36: Laboratory parameters of the sample, by Venous resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
CA 19-9 (ng/mL)	μ ±SD	208.93 ±151.6	204.90 ±657.5	205.61 ±598.7	MW: p=0.110
	M (min:max)	211.1 (1:400)	49.5 (1:5610)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD		10.55 ±23.0	10.55 ±23.0
	M (min:max)		4 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD		102.23 ±198.5	102.23 ±198.5
	M (min:max)		3.7 (1.53:400)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 39: Laboratory parameters, by Venous resection.

2.4.11.3 by living status at Oct 1, 2019

Table 36: Laboratory parameters of the sample, by Venous resections.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
CA 19-9 (ng/mL)	μ ±SD	271.32 ±747.2	97.39 ±129.7	205.61 ±598.7	MW: p=0.075
	M (min:max)	119.05 (1:5610)	38.2 (1:400)	63.95 (1:5610)
ACE (ng/mL)	μ ±SD	7.71 ±7.85	14.11 ±33.8	10.55 ±23.0	MW: p=0.479
	M (min:max)	5.3 (1.6:31.8)	3.6 (0.9:121)	4 (0.9:121)
AFP (ng/mL)	μ ±SD	202.75 ±279.0	1.71 ±0.262	102.23 ±198.5	MW: p=0.333
	M (min:max)	202.75 (5.5:400)	1.71 (1.53:1.9)	3.7 (1.53:400)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 10: Laboratory parameters, by living status at Oct 1, 2019.

2.4.12 Toxics

Only 19% of the patients were somkers, 23% consumed alcohol and none were exposed to nistrosamines. Most patients denied exposure to any toxics. None of these variables were significantly correlated to any of the main outcome.

Figure 11: Distribution of patients with any of the listed Toxics.

Table 8: Distribution of patients with any of the listed Toxics.

Variable	Total
N=	231
None / deny	141 (61.0%)
Alcohol	53 (22.9%)
Smoking	44 (19.0%)
Nitrosamines	0
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.12.1 by reinterventions

Table 9: Distribution of patients with any of the listed Toxics, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
None / deny		8 (57.1%)	116 (63.0%)	124 (62.6%)	OR=0.78 [0.26, 2.35] (p=0.776)
Alcohol		5 (35.7%)	39 (21.2%)	44 (22.2%)	OR=2.07 [0.65, 6.52] (p=0.200)
Smoking		5 (35.7%)	32 (17.4%)	37 (18.7%)	OR=2.64 [0.83, 8.40] (p=0.145)
Nitrosamines		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 12: Distribution of patients with any of the listed Toxics, by Reinterventions status.

2.4.12.2 by Venous resections

Table 30: Distribution of patients with any of the listed Toxics, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
None / deny		22 (57.9%)	119 (61.7%)	141 (61.0%)	OR=0.86 [0.42, 1.73] (p=0.717)
Alcohol		8 (21.1%)	45 (23.3%)	53 (22.9%)	OR=0.88 [0.38, 2.05] (p=0.836)
Smoking		8 (21.1%)	36 (18.7%)	44 (19.0%)	OR=1.16 [0.49, 2.75] (p=0.821)
Nitrosamines		0	0	0	OR=5.03 [0.10, 257.18] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 33: Distribution of patients with any of the listed Toxics, by Arterial resection status.

2.4.12.3 by living status at Oct 1, 2019

Table 11: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
None / deny		82 (59.0%)	59 (64.1%)	141 (61.0%)	OR=0.80 [0.47, 1.39] (p=0.491)
Alcohol		34 (24.5%)	19 (20.7%)	53 (22.9%)	OR=1.24 [0.66, 2.35] (p=0.527)
Smoking		29 (20.9%)	15 (16.3%)	44 (19.0%)	OR=1.35 [0.68, 2.69] (p=0.494)
Nitrosamines		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 14: Distribution of patients with any of the listed Toxics, by living status at Oct 1, 2019.

2.4.13 Imaging: Veins invasion

Veins invasion was observed most often by abdominal CT (4.3%) or echoendoscopy (1.7%). Ultrasound and MRI were even less effective.

Among those in who had Venous resections, 8 (10.3%) had veins invasion visible on abdominal CT compared to 2 (1.3%) among those who did not have any Venous resections. This relation was statistically significant (OR=8.63, p=0.003). All other correlations to the main outcome variables were not statisitcally significant.

Figure 15: Distribution of patients with any of the listed Imaging: Veins invasion.

Table 12: Distribution of patients with any of the listed Imaging: Veins invasion.

Variable	Total
N=	231
Ultrasound: Veins invasion	3 (1.3%)
Abdominal CT: Veins invasion	10 (4.3%)
MRI: Veins invasion	1 (0.4%)
Echoendoscopy: Veins invasion	4 (1.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.13.1 by reinterventions

Table 13: Distribution of patients with any of the listed Imaging: Veins invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Veins invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Abdominal CT: Veins invasion		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
MRI: Veins invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Echoendoscopy: Veins invasion		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 16: Distribution of patients with any of the listed Imaging: Veins invasion, by Reinterventions status.

2.4.13.2 by Venous resections

Table 31: Distribution of patients with any of the listed Imaging: Veins invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
Ultrasound: Veins invasion		0	3 (1.6%)	3 (1.3%)	OR=0.71 [0.04, 13.96] (p>0.999)
Abdominal CT: Veins invasion		6 (15.8%)	4 (2.1%)	10 (4.3%)	OR=8.86 [2.37, 33.15] (p=0.002)
MRI: Veins invasion		0	1 (0.5%)	1 (0.4%)	OR=1.67 [0.07, 41.68] (p>0.999)
Echoendoscopy: Veins invasion		2 (5.3%)	2 (1.0%)	4 (1.7%)	OR=5.31 [0.72, 38.89] (p=0.127)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 34: Distribution of patients with any of the listed Imaging: Veins invasion, by Arterial resection status.

2.4.13.3 by living status at Oct 1, 2019

Table 15: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Veins invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
Abdominal CT: Veins invasion		6 (4.3%)	4 (4.3%)	10 (4.3%)	OR=0.99 [0.27, 3.62] (p>0.999)
MRI: Veins invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Echoendoscopy: Veins invasion		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 18: Distribution of patients with any of the listed Imaging: Veins invasion, by living status at Oct 1, 2019.

2.4.14 Imaging: Arteries invasion

Arteries invasion was observed most often by abdominal CT or echoendoscopy (1.3% each). Ultrasound and MRI were even less effective. None were significatly correlated to the main outcome variables.

Figure 19: Distribution of patients with any of the listed Imaging: Arteries invasion.

Table 16: Distribution of patients with any of the listed Imaging: Arteries invasion.

Variable	Total
N=	231
Ultrasound: Arteries invasion	1 (0.4%)
Abdominal CT: Arteries invasion	3 (1.3%)
MRI: Arteries invasion	0
Echoendoscopy: Arteries invasion	3 (1.3%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.14.1 by reinterventions

Table 17: Distribution of patients with any of the listed Imaging: Arteries invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Ultrasound: Arteries invasion		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
Abdominal CT: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Echoendoscopy: Arteries invasion		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 20: Distribution of patients with any of the listed Imaging: Arteries invasion, by Reinterventions status.

2.4.14.2 by Venous resection

Table 32: Distribution of patients with any of the listed Imaging: Arteries invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
Ultrasound: Arteries invasion		0	1 (0.5%)	1 (0.4%)	OR=1.67 [0.07, 41.68] (p>0.999)
Abdominal CT: Arteries invasion		2 (5.3%)	1 (0.5%)	3 (1.3%)	OR=10.67 [0.94, 120.76] (p=0.071)
MRI: Arteries invasion		0	0	0	OR=5.03 [0.10, 257.18] (p>0.999)
Echoendoscopy: Arteries invasion		0	3 (1.6%)	3 (1.3%)	OR=0.71 [0.04, 13.96] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 35: Distribution of patients with any of the listed Imaging: Arteries invasion, by Arterial resection status.

2.4.14.3 by living status at Oct 1, 2019

Table 19: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Ultrasound: Arteries invasion		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Abdominal CT: Arteries invasion		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
MRI: Arteries invasion		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Echoendoscopy: Arteries invasion		1 (0.7%)	2 (2.2%)	3 (1.3%)	OR=0.33 [0.03, 3.65] (p=0.565)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 22: Distribution of patients with any of the listed Imaging: Arteries invasion, by living status at Oct 1, 2019.

2.4.15 Vascular invasion

Approximatively 86% of the patients had no vascular invason. Among those who had any, the portal and superior mesenteric veins were most often affected. In those cases, Venous resections had significantly higher odds of being performed (portal vein: OR=11.90, p<0.001; superior mesenteric vein: OR=19.83, p<0.001). Patients with no vascular inARlvement had significantly lower odds of being dead at Oct-1-2019 (OR=0.35, p=0.021).

Figure 23: Distribution of patients with any of the listed Vascular invasion.

Table 20: Distribution of patients with any of the listed Vascular invasion.

Variable	Total
N=	231
Portal vein	18 (7.8%)
Superior mesenteric vein	10 (4.3%)
Confluent	3 (1.3%)
Celiac trunk	0
Superior mesenteric artery	4 (1.7%)
Common hepatic artery	0
Splenic artery	0
Other	1 (0.4%)
No vascular invasion	198 (85.7%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.15.1 by reinterventions

Table 21: Distribution of patients with any of the listed Vascular invasion, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Portal vein		1 (7.1%)	17 (9.2%)	18 (9.1%)	OR=0.76 [0.09, 6.14] (p>0.999)
Superior mesenteric vein		1 (7.1%)	9 (4.9%)	10 (5.1%)	OR=1.50 [0.18, 12.73] (p=0.528)
Confluent		0	3 (1.6%)	3 (1.5%)	OR=1.79 [0.09, 36.32] (p>0.999)
Celiac trunk		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Superior mesenteric artery		0	4 (2.2%)	4 (2.0%)	OR=1.38 [0.07, 26.97] (p>0.999)
Common hepatic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Splenic artery		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Other		0	1 (0.5%)	1 (0.5%)	OR=4.22 [0.16, 108.25] (p>0.999)
No vascular invasion		12 (85.7%)	153 (83.2%)	165 (83.3%)	OR=1.22 [0.26, 5.70] (p>0.999)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 24: Distribution of patients with any of the listed Vascular invasion, by Reinterventions status.

2.4.15.2 by Venous resection

Table 33: Distribution of patients with any of the listed Vascular invasion, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
Portal vein		14 (36.8%)	4 (2.1%)	18 (7.8%)	OR=27.56 [8.39, 90.56] (p<0.001)
Superior mesenteric vein		9 (23.7%)	1 (0.5%)	10 (4.3%)	OR=59.59 [7.28, 487.84] (p<0.001)
Confluent		1 (2.6%)	2 (1.0%)	3 (1.3%)	OR=2.58 [0.23, 29.21] (p=0.418)
Celiac trunk		0	0	0	OR=5.03 [0.10, 257.18] (p>0.999)
Superior mesenteric artery		0	4 (2.1%)	4 (1.7%)	OR=0.55 [0.03, 10.37] (p>0.999)
Common hepatic artery		0	0	0	OR=5.03 [0.10, 257.18] (p>0.999)
Splenic artery		0	0	0	OR=5.03 [0.10, 257.18] (p>0.999)
Other		0	1 (0.5%)	1 (0.4%)	OR=1.67 [0.07, 41.68] (p>0.999)
No vascular invasion		15 (39.5%)	183 (94.8%)	198 (85.7%)	OR=0.04 [0.01, 0.09] (p<0.001)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 36: Distribution of patients with any of the listed Vascular invasion, by Arterial resection status.

2.4.15.3 by living status at Oct 1, 2019

Table 23: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Portal vein		13 (9.4%)	5 (5.4%)	18 (7.8%)	OR=1.80 [0.62, 5.22] (p=0.325)
Superior mesenteric vein		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Confluent		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Celiac trunk		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Superior mesenteric artery		4 (2.9%)	0	4 (1.7%)	OR=6.14 [0.33, 115.48] (p=0.153)
Common hepatic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Splenic artery		0	0	0	OR=0.66 [0.01, 33.71] (p>0.999)
Other		0	1 (1.1%)	1 (0.4%)	OR=0.22 [0.01, 5.43] (p=0.398)
No vascular invasion		113 (81.3%)	85 (92.4%)	198 (85.7%)	OR=0.36 [0.15, 0.86] (p=0.021)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 26: Distribution of patients with any of the listed Vascular invasion, by living status at Oct 1, 2019.

2.4.16 Complications

Gastric staxis (10.4%) and suppuration (9.5%) were the most common complications. Pancreatic fistula, Digestive fistula, Pancreatitis, Suppuration, Intraperitoneala hemorrhage and Cardiovascular were significantly associated to higher odds of reinterventions. None were significantly associated to mortality or Venous resections.

Figure 27: Distribution of patients with any of the listed Complications.

Table 24: Distribution of patients with any of the listed Complications.

Variable	Total
N=	231
Pancreatic fistula	16 (6.9%)
Bile ducts fistula	7 (3.0%)
Digestive fistula	3 (1.3%)
Hemorrhage	11 (4.8%)
Gastric stasis	24 (10.4%)
Pancreatitis	3 (1.3%)
Peritonits	1 (0.4%)
Suppuration	22 (9.5%)
Intraperitoneala hemorrhage	2 (0.9%)
Septic shock	1 (0.4%)
Pulmonar	8 (3.5%)
Cardiovascular	10 (4.3%)
Hepatic	4 (1.7%)
Other	22 (9.5%)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max);

2.4.16.1 by reinterventions

Table 25: Distribution of patients with any of the listed Complications, by reinterventions.

Variable	Details	yes	no	Total	Statistics
Reinterventions		14 (7.1%)	184 (92.9%)	198
Pancreatic fistula		4 (28.6%)	11 (6.0%)	15 (7.6%)	OR=6.29 [1.70, 23.31] (p=0.014)
Bile ducts fistula		2 (14.3%)	5 (2.7%)	7 (3.5%)	OR=5.97 [1.05, 34.02] (p=0.080)
Digestive fistula		3 (21.4%)	0	3 (1.5%)	OR=112.30 [5.47, 2 306.96] (p<0.001)
Hemorrhage		2 (14.3%)	9 (4.9%)	11 (5.6%)	OR=3.24 [0.63, 16.71] (p=0.177)
Gastric stasis		2 (14.3%)	20 (10.9%)	22 (11.1%)	OR=1.37 [0.29, 6.55] (p=0.658)
Pancreatitis		2 (14.3%)	1 (0.5%)	3 (1.5%)	OR=30.50 [2.58, 360.76] (p=0.013)
Peritonits		1 (7.1%)	0	1 (0.5%)	OR=41.00 [1.59, 1 055.25] (p=0.071)
Suppuration		4 (28.6%)	16 (8.7%)	20 (10.1%)	OR=4.20 [1.18, 14.92] (p=0.039)
Intraperitoneala hemorrhage		2 (14.3%)	0	2 (1.0%)	OR=73.80 [3.36, 1 621.79] (p=0.005)
Septic shock		0	0	0	OR=12.72 [0.24, 664.95] (p>0.999)
Pulmonar		2 (14.3%)	6 (3.3%)	8 (4.0%)	OR=4.94 [0.90, 27.17] (p=0.102)
Cardiovascular		4 (28.6%)	6 (3.3%)	10 (5.1%)	OR=11.87 [2.88, 48.92] (p=0.003)
Hepatic		1 (7.1%)	3 (1.6%)	4 (2.0%)	OR=4.64 [0.45, 47.80] (p=0.256)
Other		5 (35.7%)	14 (7.6%)	19 (9.6%)	OR=6.75 [1.99, 22.88] (p=0.005)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 28: Distribution of patients with any of the listed Complications, by Reinterventions status.

2.4.16.2 by Venous resection

Table 34: Distribution of patients with any of the listed Complications, by Arterial resections.

Variable	Details	yes	no	Total	Statistics
Venous resection		38 (16.5%)	193 (83.5%)	231
Pancreatic fistula		3 (7.9%)	13 (6.7%)	16 (6.9%)	OR=1.19 [0.32, 4.38] (p=0.732)
Bile ducts fistula		0	7 (3.6%)	7 (3.0%)	OR=0.32 [0.02, 5.77] (p=0.603)
Digestive fistula		1 (2.6%)	2 (1.0%)	3 (1.3%)	OR=2.58 [0.23, 29.21] (p=0.418)
Hemorrhage		3 (7.9%)	8 (4.1%)	11 (4.8%)	OR=1.98 [0.50, 7.84] (p=0.396)
Gastric stasis		2 (5.3%)	22 (11.4%)	24 (10.4%)	OR=0.43 [0.10, 1.92] (p=0.385)
Pancreatitis		1 (2.6%)	2 (1.0%)	3 (1.3%)	OR=2.58 [0.23, 29.21] (p=0.418)
Peritonits		0	1 (0.5%)	1 (0.4%)	OR=1.67 [0.07, 41.68] (p>0.999)
Suppuration		2 (5.3%)	20 (10.4%)	22 (9.5%)	OR=0.48 [0.11, 2.15] (p=0.544)
Intraperitoneala hemorrhage		1 (2.6%)	1 (0.5%)	2 (0.9%)	OR=5.19 [0.32, 84.83] (p=0.303)
Septic shock		0	1 (0.5%)	1 (0.4%)	OR=1.67 [0.07, 41.68] (p>0.999)
Pulmonar		2 (5.3%)	6 (3.1%)	8 (3.5%)	OR=1.73 [0.34, 8.92] (p=0.621)
Cardiovascular		1 (2.6%)	9 (4.7%)	10 (4.3%)	OR=0.55 [0.07, 4.49] (p>0.999)
Hepatic		1 (2.6%)	3 (1.6%)	4 (1.7%)	OR=1.71 [0.17, 16.91] (p=0.515)
Other		7 (18.4%)	15 (7.8%)	22 (9.5%)	OR=2.68 [1.01, 7.10] (p=0.063)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 37: Distribution of patients with any of the listed Complications, by Arterial resection status.

2.4.16.3 by living status at Oct 1, 2019

Table 27: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

Variable	Details	no	yes	Total	Statistics
Alive at 1-Oct-2019		139 (60.2%)	92 (39.8%)	231
Pancreatic fistula		9 (6.5%)	7 (7.6%)	16 (6.9%)	OR=0.84 [0.30, 2.34] (p=0.794)
Bile ducts fistula		6 (4.3%)	1 (1.1%)	7 (3.0%)	OR=4.11 [0.49, 34.67] (p=0.248)
Digestive fistula		3 (2.2%)	0	3 (1.3%)	OR=4.74 [0.24, 92.92] (p=0.278)
Hemorrhage		8 (5.8%)	3 (3.3%)	11 (4.8%)	OR=1.81 [0.47, 7.02] (p=0.533)
Gastric stasis		14 (10.1%)	10 (10.9%)	24 (10.4%)	OR=0.92 [0.39, 2.17] (p=0.830)
Pancreatitis		2 (1.4%)	1 (1.1%)	3 (1.3%)	OR=1.33 [0.12, 14.87] (p>0.999)
Peritonits		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Suppuration		14 (10.1%)	8 (8.7%)	22 (9.5%)	OR=1.18 [0.47, 2.93] (p=0.821)
Intraperitoneala hemorrhage		2 (1.4%)	0	2 (0.9%)	OR=3.36 [0.16, 70.87] (p=0.519)
Septic shock		1 (0.7%)	0	1 (0.4%)	OR=2.00 [0.08, 49.72] (p>0.999)
Pulmonar		7 (5.0%)	1 (1.1%)	8 (3.5%)	OR=4.83 [0.58, 39.89] (p=0.150)
Cardiovascular		9 (6.5%)	1 (1.1%)	10 (4.3%)	OR=6.30 [0.78, 50.59] (p=0.054)
Hepatic		3 (2.2%)	1 (1.1%)	4 (1.7%)	OR=2.01 [0.21, 19.60] (p>0.999)
Other		18 (12.9%)	4 (4.3%)	22 (9.5%)	OR=3.27 [1.07, 10.01] (p=0.038)
μ ±SD = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-Whitney Test; Welch = Welch T-Test (not assuming equal variances); OR/RR = odds-ratio / risk-ratio [95% CI] and p value from Fisher test); V = Cramér V (p value from Chi² test);

Figure 30: Distribution of patients with any of the listed Complications, by living status at Oct 1, 2019.

3 References

1. R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.