Clinical and pathological features of five-year survivors after pancreatectomy for pancreatic adenocarcinoma

Kimura, Kenjiro; Amano, Ryosuke; Nakata, Bunzo; Yamazoe, Sadaaki; Hirata, Keiichiro; Murata, Akira; Miura, Kotaro; Nishio, Kenji; Hirakawa, Toshiki; Ohira, Masaichi; Hirakawa, Kosei

doi:10.1186/1477-7819-12-360

Cited by 44 publications

(49 citation statements)

References 27 publications

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“…CA19-9, CEA, SPan-1, and DUPAN-2 have also been reported to be useful and prognostic factors for PDAC [15, 23, 24]. In this study, we identified CA19-9 and CEA as independent predictors of early recurrence after pancreatic resection in PDAC patients.…”

Section: Discussionmentioning

confidence: 50%

Predictive Early Recurrence Factors of Preoperative Clinicophysiological Findings in Pancreatic Cancer

et al. 2018

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Background: We aimed to evaluate the use of preoperative clinicophysiological parameters as predictive risk factors for early recurrence of pancreatic ductal adenocarcinoma (PDAC) after curative resection. Methods: A total of 260 patients who underwent pancreatic resection for PDAC between 2007 and 2015 were examined retrospectively. We divided the patients into those with early recurrence (within 6 months; group A, n = 52) and those with relapse within ≥6 months or without recurrence (group B, n = 208). Data regarding clinicophysiological parameters were analyzed as predictors of disease-free survival (DFS). These factors were analyzed by χ² tests on univariate analysis and Cox proportional hazard models on multivariate analyses. Kaplan-Meier survival curves were generated using log-rank tests. Results: Groups A and B had significantly different preoperative carbohydrate antigen 19-9 (CA19-9) levels, carcinoembryonic antigen (CEA) levels, and curability. Univariate and multivariate analysis showed that CA19-9 and CEA were independent prognostic factors for early recurrence. Patients with CA19-9 levels > 124.65 U/mL had significantly shorter DFS than those with lower levels, as did patients with CEA levels > 4.45 ng/mL. Conclusions: Our results show that elevated CA19-9 (> 124.65 U/mL) and CEA (> 4.45 ng/mL) were independent predictors of early recurrence after pancreatic resection in PDAC patients.

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Section: Discussionmentioning

confidence: 50%

Predictive Early Recurrence Factors of Preoperative Clinicophysiological Findings in Pancreatic Cancer

et al. 2018

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“…Only 20% of patients with pancreatic cancer are candidates for potentially radical resection [2]. Surgical resection is associated with a median OS of 11 to 23 months and with a 5-year OS of about 20% [3, 4]. Furthermore, 60% of patients experience local and systemic relapse within the first 12 months after curative surgery [3].…”

Section: Introductionmentioning

confidence: 99%

Preoperative predictors for early recurrence of resectable pancreatic cancer

et al. 2017

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BackgroundThe first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation might cause early recurrence. The present study aimed to identify preoperative clinicopathological features of early recurrence after curative resection of RPC.MethodsNinety RPC patients who underwent curative resection between 2000 and 2014 at our institution were retrospectively analyzed.ResultsOf the 90 patients, 32 had recurrence within 1 year. Univariate analysis demonstrated that preoperative serum carbohydrate antigen (CA19-9) ≥529 U/mL (P = 0.0011), preoperative serum s-pancreas-1 antigen (SPan-1) ≥37 U/mL (P = 0.0038), and histological grades G2–G4 (P = 0.0158) were significantly associated with recurrence within 1 year after curative resection. Multivariate analysis demonstrated that preoperative serum CA19-9 ≥ 529 U/mL (P = 0.0477) and histological grade G2–G4 (P = 0.0129) were independent predictors of recurrence within 1 year. Recurrent cases within 1 year postoperatively had significantly more distant metastasis than cases with no recurrence within 1 year (P < 0.001).ConclusionsPreoperative serum CA19-9 ≥ 529 U/mL and histological grades G2–G4 were independent predictive factors for recurrence within 1 year after pancreatectomy for RPC. Furthermore, recurrent cases within 1 year had more frequent distant metastasis than cases with no recurrence within 1 year. These results suggest that RPC patients with preoperative serum CA19-9 ≥ 529 U/mL should receive preoperative therapy rather than surgery.

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“…A quarter of patients have a locally advanced disease with approximately 53% of patients presenting with distant metastases. Several studies have analysed the prognostic factors of long-term survival and evaluated the 5-year survival in resected patients [6][7][8][9][10][11][12][13][14][15] (Tables 1 and 2). …”

Section: Introductionmentioning

confidence: 99%

Long-term survival after resections for pancreatic ductal adenocarcinoma. Single centre study

Loveček¹,

Skalický²,

Klos³

et al. 2016

BIOMED PAP

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Aim. To analyse the 5-year survival rate of patients undergoing radical surgery for pancreatic ductal adenocarcinoma (PDAC) and to identify prognostic factors. Methods. A prospectively maintained database of 90 consecutive patients who underwent radical resection for PDAC was analysed. Survival was evaluated using the Kaplan-Meier method. Log-rank test and Cox regression analysis were used for the evaluation of prognostic factors. P values less than 0.05 were considered significant. Results. Mean age (± standard deviation) was 63.2±8.6 years (female 28.9% and male 71.1%). Tumour localisation was in the head in 76 (84.5%), multifocal in 3 (3.3%) and in the body/tail in 11 (12.2%). Pancreatic head resection was performed in 75 (83.3%), total pancreatectomy in 4 (4.4%) and distal pancreatectomy with splenectomy in 11 (12.2%), with standard lymphadenectomy. Venous resection was in 4 (4.4%). Thirty-day and in-hospital mortality occurred in 1 (1.1%), 90-day mortality was 3.3%. On univariate analysis absence of perineural and vascular invasion, stage, absence of lymph node infiltration and no need for transfusion were associated with improved overall survival. On multivariate analysis vascular invasion HR=3.137 (95%CI: 1.692-5.816; P = 0.0003) and postoperative complications HR=2. ; P = 0.008) were identified as significant independent predictors of survival. The five-year survival rate was 18.9%, with five-year recurrence-free survival of 16.7%. Conclusion. Vascular invasion and postoperative complications were independent prognostic factors after curative resections of pancreatic cancer in studied cohort.

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Clinical and pathological features of five-year survivors after pancreatectomy for pancreatic adenocarcinoma

Cited by 44 publications

References 27 publications

Predictive Early Recurrence Factors of Preoperative Clinicophysiological Findings in Pancreatic Cancer

Predictive Early Recurrence Factors of Preoperative Clinicophysiological Findings in Pancreatic Cancer

Preoperative predictors for early recurrence of resectable pancreatic cancer

Long-term survival after resections for pancreatic ductal adenocarcinoma. Single centre study

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