Prediction of residual tumor and overall survival after first-line surgery in patients with pancreatic ductal adenocarcinoma using preoperative magnetic resonance imaging findings.

Autor:	Bae JS; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim JH; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Kang HJ; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Han JK; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Acta radiologica (Stockholm, Sweden : 1987) [Acta Radiol] 2022 Apr; Vol. 63 (4), pp. 435-446. Date of Electronic Publication: 2021 Mar 08.
DOI:	10.1177/0284185121999998
Abstrakt:	Background: Complete resection is the only potentially curative treatment in patients with pancreatic ductal adenocarcinoma (PDA) and is associated with a longer overall survival (OS) than incomplete resection of tumor. Hence, prediction of the resection status after surgery would help predict the prognosis of patients with PDA. Purpose: To predict residual tumor (R) classification and OS in patients who underwent first-line surgery for PDA using preoperative magnetic resonance imaging (MRI). Material and Methods: In this study, 210 patients with PDA who underwent MRI and first-line surgery were randomly categorized into a test group (n=150) and a validation group (n=60). The R classification was divided into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). Preoperative MRI findings associated with R classification and OS were assessed by using logistic regression and Cox proportional hazard models. In addition, the prediction models for the R classification and OS were validated using calibration plots and C statistics. Results: On preoperative MRI, portal vein encasement (odds ratio 4.755) was an independent predictor for R1/R2 resection ( P =0.040). Tumor size measured on MRI (hazard ratio [HR] per centimeter 1.539) was a predictor of OS, along with pathologic N1 and N2 stage (HR 1.944 and 3.243, respectively), R1/R2 resection (HR 3.273), and adjuvant chemoradiation therapy (HR 0.250) ( P <0.050). Calibration plots demonstrated satisfactory predictive performance. Conclusion: Preoperative MRI was valuable for predicting R1/R2 resection using portal vein encasement. Tumor size measured on MRI was useful for the prediction of OS after first-line surgery for PDA.
Databáze:	MEDLINE
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