Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasm and derivation of a prognostic model: An international multicenter study (ADENO-IPMN study).

Autor: Lucocq J; Department of General surgery, NHS Lothian, UK., Joseph N; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., Hawkyard J; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., Haugk B; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., White S; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., Lye J; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., Parkinson D; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK., Mownah O; Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK., Menon K; Department of Hepatobiliary & Pancreatic Surgery, King's College Hospital, Denmark Hill, London, UK., Furukawa T; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan., Hirose Y; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan., Sasahira N; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan., Inoue Y; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Hepato-Biliary-Pancreatic Medicine Department, Tokyo, Japan., Mittal A; Royal North Shore Hospital, Sydney, NSW, Australia., Samra J; Royal North Shore Hospital, Sydney, NSW, Australia., Sheen A; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia., Feretis M; Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK., Balakrishnan A; Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK., Ceresa C; Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK., Davidson B; Hepatobiliary and Pancreatic Surgery Unit, The Royal Free Hospital, London, UK., Pande R; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK., Dasari B; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK., Roberts K; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, UK., Tanno L; Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK., Karavias D; Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK., Helliwell J; Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Young A; Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Marks K; Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Nunes Q; Department of Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, UK., Urbonas T; Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK., Silva M; Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK., Gordon-Weeks A; Oxford Hepato-Pancreato-Biliary (HPB) Surgical Unit, Oxford University Hospitals NHS Foundation Trust, UK., Barrie J; Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK., Gomez D; Nottingham Hepato-Pancreatico-Biliary (HPB) Service, Nottingham University Hospitals NHS Foundation Trust, UK., van Laarhoven S; Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation trust, UK., Nawara H; Department of Hepatobiliary and Pancreatic Surgery, University Hospitals Bristol & Weston NHS Foundation trust, UK., Doyle J; Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK., Bhogal R; Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, London, UK., Harrison E; Department of Clinical Surgery, University of Edinburgh, UK., Roalso M; Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway., Ciprani D; Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK., Aroori S; Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK., Ratnayake B; Hepato-Pancreatico-Biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, NZ., Koea J; Hepato-Pancreatico-Biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, NZ., Capurso G; Digestive and Disease Unit, S. Andrea Hospital, Rome, Italy; Pancreas Center, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University, Milan, Italy., Stättner S; Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Austria., Bellotti R; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK., Alsaoudi T; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK., Bhardwaj N; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK., Rajesh S; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, UK., Jeffery F; Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, NZ., Connor S; Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, NZ., Cameron A; Wolfson Wohl Cancer Research Center, Research Institute of Cancer Sciences, University of Glasgow, UK., Jamieson N; Wolfson Wohl Cancer Research Center, Research Institute of Cancer Sciences, University of Glasgow, UK., Gill A; Royal North Shore Hospital, Sydney, NSW, Australia; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia., Soreide K; Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway., Pandanaboyana S; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK. Electronic address: sanjay.pandanaboyana@ncl.ac.uk.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Sep; Vol. 176 (3), pp. 890-898. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1016/j.surg.2024.05.010
Abstrakt: Background: Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasms are unknown. This study determines predictors of long-term (>5 years) disease-free survival and recurrence in adenocarcinoma arising from intraductal papillary mucinous neoplasms and derives a prognostic model for disease-free survival.
Methods: Consecutive patients who underwent pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms in 18 academic pancreatic centers in Europe and Asia between 2010 to 2017 with at least 5-year follow-up were identified. Factors associated with disease-free survival were determined using Cox proportional hazards model. Internal validation was performed, and discrimination and calibration indices were assessed.
Results: In the study, 288 patients (median age, 70 years; 52% male) were identified; 140 (48%) patients developed recurrence after a median follow-up of 98 months (interquartile range, 78.4-123), 57 patients (19.8%) developed locoregional recurrence, and 109 patients (37.8%) systemic recurrence. At 5 years after resection, the overall and disease-free survival was 46.5% (134/288) and 35.0% (101/288), respectively. On Cox proportional hazards model analysis, multivisceral resection (hazard ratio, 2.20; 95% confidence interval, 1.06-4.60), pancreatic tail location (hazard ratio, 2.34; 95% confidence interval, 1.22-4.50), poor tumor differentiation (hazard ratio, 2.48; 95% confidence interval, 1.10-5.30), lymphovascular invasion (hazard ratio, 1.74; 95% confidence interval, 1.06-2.88), and perineural invasion (hazard ratio, 1.83; 95% confidence interval, 1.09-3.10) were negatively associated with long-term disease-free survival. The final predictive model incorporated 8 predictors and demonstrated good predictive ability for disease-free survival (C-index, 0.74; calibration, slope 1.00).
Conclusion: A third of patients achieve long-term disease-free survival (>5 years) after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms. The predictive model developed in the current study can be used to estimate the probability of long-term disease-free survival.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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