Survival effects of adjuvant gemcitabine plus S-1 chemotherapy on pancreatic carcinoma stratified by preoperative resectability status

Murakami, Yoshiaki; Uemura, Kenichiro; Hashimoto, Yasushi; Kondo, Naru; Nakagawa, Noritoshi; Takahashi, Shinya; Shintakuya, Ryuta; Sueda, Taijiro

doi:10.1002/jso.24156

Cited by 18 publications

(2 citation statements)

References 25 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease, and the five-year survival rate is lower than 8% (1)(2)(3). Although surgery remains the only potential chance for a cure, some patients with localized PDAC are not appropriated for upfront surgery or even unresectable due to the involvement of peripancreatic vessels (3)(4)(5)(6)(7)(8). Regarding patients with peripancreatic arterial involvement, upfront surgery is known to be associated with a low resection rate and a deteriorated long-term survival (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…Although surgery remains the only potential chance for a cure, some patients with localized PDAC are not appropriated for upfront surgery or even unresectable due to the involvement of peripancreatic vessels (3)(4)(5)(6)(7)(8). Regarding patients with peripancreatic arterial involvement, upfront surgery is known to be associated with a low resection rate and a deteriorated long-term survival (4,5). In contrast, for patients with isolated peripancreatic venous [portal vein-superior mesenteric vein (PV-SMV)] involvement, long-term survival after extended pancreaticoduodenectomy (PD) with venous resection may be comparable to that achieved by standard PD without venous resection (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiomics-Assisted Presurgical Prediction for Surgical Portal Vein-Superior Mesenteric Vein Invasion in Pancreatic Ductal Adenocarcinoma

Chen

Zhou

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Objectives To develop a radiomics signature for predicting surgical portal vein-superior mesenteric vein (PV-SMV) in patients with pancreatic ductal adenocarcinoma (PDAC) and measure the effect of providing the predictions of radiomics signature to radiologists with different diagnostic experiences during imaging interpretation. Methods Between February 2008 and June 2020, 146 patients with PDAC in pancreatic head or uncinate process from two institutions were retrospectively included and randomly split into a training (n = 88) and a validation (n =58) cohort. Intraoperative vascular exploration findings were used to identify surgical PV-SMV invasion. Radiomics features were extracted from the portal venous phase CT images. Radiomics signature was built with a linear elastic-net regression model. Area under receiver operating characteristic curve (AUC) of the radiomics signature was calculated. A senior and a junior radiologist independently review CT scans and made the diagnosis for PV-SMV invasion both with and without radiomics score (Radscore) assistance. A 2-sided Pearson’s chi-squared test was conducted to evaluate whether there was a difference in sensitivity, specificity, and accuracy between the radiomics signature and the unassisted radiologists. To assess the incremental value of providing Radscore predictions to the radiologists, we compared the performance between unassisted evaluation and Radscore-assisted evaluation by using the McNemar test. Results Numbers of patients identified as presence of surgical PV-SMV invasion were 33 (37.5%) and 19 (32.8%) in the training and validation cohort, respectively. The radiomics signature achieved an AUC of 0.848 (95% confidence interval, 0.724–0.971) in the validation cohort and had a comparable sensitivity, specificity, and accuracy as the senior radiologist in predicting PV-SMV invasion (all p -values > 0.05). Providing predictions of radiomics signature increased both radiologists’ sensitivity in identifying PV-SMV invasion, while only the increase of the junior radiologist was significant (63.2 vs 89.5%, p -value = 0.025) instead of the senior radiologist (73.7 vs 89.5%, p -value = 0.08). Both radiologists’ accuracy had no significant increase when provided radiomics signature assistance (both p -values > 0.05). Conclusions The radiomics signature can predict surgical PV-SMV invasion in patients with PDAC and may have incremental value to the diagnostic performance of radiologists during imaging interpretation.

show abstract