Prognostic Factors for Early Recurrence After Resection of Pancreatic Cancer: A Systematic Review and Meta-Analysis.

Autor:	Leonhardt CS; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria; Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom. Electronic address: carl-stephan.leonhardt@meduniwien.ac.at., Gustorff C; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Klaiber U; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Le Blanc S; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria., Stamm TA; Institute of Outcomes Research, Center for Medical Data Science, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria., Verbeke CS; Department of Pathology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Prager GW; Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria., Strobel O; Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
Jazyk:	angličtina
Zdroj:	Gastroenterology [Gastroenterology] 2024 Oct; Vol. 167 (5), pp. 977-992. Date of Electronic Publication: 2024 May 31.
DOI:	10.1053/j.gastro.2024.05.028
Abstrakt:	Background & Aims: More than half of pancreatic ductal adenocarcinomas (PDACs) recur within 12 months after curative-intent resection. This systematic review and meta-analysis was conducted to identify all reported prognostic factors for early recurrence in resected PDACs. Methods: After a systematic literature search, a meta-analysis was conducted using a random effects model. Separate analyses were performed for adjusted vs unadjusted effect estimates as well as reported odds ratios (ORs) and hazard ratios (HRs). Risk of bias was assessed using the Quality in Prognostic Studies tool, and evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation recommendations. Results: After 2903 abstracts were screened, 65 studies were included. Of these, 28 studies (43.1%) defined early recurrence as evidence of recurrence within 6 months, whereas 34 (52.3%) defined it as evidence of recurrence within 12 months after surgery. Other definitions were uncommon. Analysis of unadjusted ORs and HRs revealed 41 and 5 prognostic factors for early recurrence within 6 months, respectively. When exclusively considering adjusted data, we identified 25 and 10 prognostic factors based on OR and HR, respectively. Using a 12-month definition, we identified 38 (OR) and 15 (HR) prognostic factors from unadjusted data and 38 (OR) and 30 (HR) prognostic factors from adjusted data, respectively. On the basis of frequency counts of adjusted data, preoperative carbohydrate antigen 19-9, N status, nondelivery of adjuvant therapy, grading, and tumor size based on imaging were identified as key prognostic factors for early recurrence. Conclusions: Reported prognostic factors of early recurrence vary considerably. Identified key prognostic factors could aid in the development of a risk stratification framework for early recurrence. However, prospective validation is necessary. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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