Proposed preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after surgical resection: A multi-center retrospective study

被引：124

作者：

Matsumoto, Ippei ^{[1
,2
,3
]}

Murakami, Yoshiaki ^{[1
,4
]}

Shinzeki, Makoto ^{[1
,2
]}

Asari, Sadaki ^{[1
,2
]}

Goto, Tadahiro ^{[1
,2
]}

Tani, Masaji ^{[1
,5
]}

Motoi, Fuyuhiko ^{[1
,6
]}

Uemura, Kenichiro ^{[1
,4
]}

Sho, Masayuki ^{[1
,7
]}

Satoi, Sohei ^{[1
,8
]}

Honda, Goro ^{[1
,9
]}

Yamaue, Hiroki ^{[1
,5
]}

Unno, Michiaki ^{[1
,6
]}

Akahori, Takahiro ^{[1
,7
]}

Kwon, A-Hon ^{[1
,8
]}

Kurata, Masanao ^{[1
,9
]}

Ajiki, Tetsuo ^{[1
,2
]}

Fukumoto, Takumi ^{[1
,2
]}

Ku, Yonson ^{[1
,2
]}

机构：

[1] Multictr Study Grp Pancreatobiliary Surg MSG PBS, Tokyo, Japan

[2] Kobe Univ, Grad Sch Med, Dept Surg, Div Hepatobiliary Pancreat Surg, Kobe, Hyogo 657, Japan

[3] Kinki Univ, Fac Med, Dept Surg, Osaka 5898511, Japan

[4] Hiroshima Univ, Inst Biomed & Hlth Sci, Dept Surg, Hiroshima, Japan

[5] Wakayama Med Univ, Dept Surg 2, Wakayama, Japan

[6] Tohoku Univ, Dept Surg, Div Gastroenterol Surg, Sendai, Miyagi 980, Japan

[7] Nara Med Univ, Dept Surg, Nara, Japan

[8] Kansai Med Univ, Dept Surg, Hirakata, Osaka, Japan

[9] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Surg, Tokyo, Japan

来源：

PANCREATOLOGY | 2015年 / 15卷 / 06期

关键词：

Early recurrence; Pancreatic cancer; Preoperative risk factor; Resectable pancreatic cancer; Pancreatic ductal adenocarcinoma; Multi-center study; RANDOMIZED CONTROLLED-TRIAL; ADJUVANT CHEMOTHERAPY; PROGNOSTIC SCORE; PHASE-II; CONCURRENT RADIOTHERAPY; ORAL S-1; CANCER; GEMCITABINE; CARCINOMA; SURVIVAL;

D O I：

10.1016/j.pan.2015.09.008

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background/objective: Although surgical resection remains the only chance for cure in patients with pancreatic ductal adenocarcinoma (PDAC), postoperative early recurrence (ER) is frequently encountered. The purpose of this study is to determine the preoperative predictive factors for ER after upfront surgical resection. Methods: Between 2001 and 2012, 968 patients who underwent upfront surgery with R0 or R1 resection for PDAC at seven high-volume centers in Japan were retrospectively reviewed. ER was defined as relapse within 6 months after surgery. Study analysis stratified by resectable (R) and borderline resectable (BR) PDACs was conducted according to the National Comprehensive Cancer Network guidelines. Results: ER occurred in 239 patients (25%) with a median survival time (MST) of 8.8 months. Modified Glasgow prognostic score = 2 (odds ratio (OR) 2.06, 95% confidence interval (CI) 1.05-3.95; P = 0.044), preoperative CA19-9 >= 300 U/ml (OR 1.94, 1.29-2.90; P = 0.003), and tumor size >= 30 mm (OR 1.72, 1.16 -2.56; P = 0.006), were identified as preoperative independent predictive risk factors for ER in patients with R-PDAC. In the R-PDAC patients, MST was 35.5, 263, and 15.9 months in patients with 0, 1 and >= 2 risk factors, respectively. There were significant differences in overall survival between the three groups (P < 0.001). No preoperative risk factors were identified in BR-PDAC patients with a high rate of ER (39%). Conclusions: There is a high-risk subset for ER even in patients with R-PDAC and a simple risk scoring system is useful for prediction of ER. Copyright (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.

引用

页码：674 / 680

页数：7

共 37 条

[1] Resectable Pancreatic Cancer: Who Really Benefits From Resection? [J].