Evaluation of preoperative prognostic factors in patients with resectable invasive intraductal papillary mucinous carcinoma

Autor: Toru Furukawa, Takehisa Yazawa, Masahiro Shiihara, Ryota Higuchi, Shuichiro Uemura, Masakazu Yamamoto, Wataru Izumo
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Multivariate analysis
CA-19-9 Antigen
Kaplan-Meier Estimate
030230 surgery
Risk Assessment
Gastroenterology
Disease-Free Survival
03 medical and health sciences
Pancreatectomy
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Humans
Medicine
Mucinous carcinoma
Neoplasm Invasiveness
In patient
Risk factor
Aged
Retrospective Studies
Aged
80 and over
Tumor size
business.industry
Standard treatment
Hazard ratio
Middle Aged
Prognosis
medicine.disease
Adenocarcinoma
Mucinous
Pancreatic Neoplasms
Survival Rate
Chemotherapy
Adjuvant
Lymphatic Metastasis
030220 oncology & carcinogenesis
Preoperative Period
Tubular Adenocarcinoma
Female
Surgery
Neoplasm Recurrence
Local
business
Carcinoma
Pancreatic Ductal
Follow-Up Studies
Zdroj: Surgery. 168:994-1002
ISSN: 0039-6060
Popis: Background Upfront surgery is the standard treatment for resectable invasive intraductal papillary mucinous carcinoma; however, recurrence is common. Therefore, we investigated the recurrence, surgical outcome, and preoperative prognostic factors for recurrence in patients with resectable invasive intraductal papillary mucinous carcinoma. Methods We analyzed 111 patients who underwent upfront surgery for resectable invasive intraductal papillary mucinous carcinoma between 2000 and 2017 and evaluated the relationship among clinicopathologic factors, recurrence, and outcomes. Results The 5-year recurrence-free survival and disease-specific survival rates were 61% and 74%, respectively. The median time to recurrence was 1.1 years. In multivariate analysis, carbohydrate antigen 19-9 ≥83 U/mL (hazard ratio: 2.8 and 3.1), tumor size ≥2.2 cm (hazard ratio: 3.5 and 4.7), and pathologic tubular adenocarcinoma grade 2 (hazard ratio: 3.1 and 5.2) were risk factors for a shorter recurrence-free survival and disease-specific survival, respectively. Lymph node metastasis (hazard ratio: 3.9) was also a risk factor for a shorter disease-specific survival. When examining outcomes according to preoperatively measurable factors (carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm), the 5-year recurrence rates in patients with none (n = 47), 1 (n = 46), and both (n = 18) risk factors were 17%, 48%, and 78%, respectively. Five-year disease-specific survival rates in patients with none, 1, and both preoperative risk factors were 95%, 69%, and 31%, respectively. Conclusion Carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm were independent preoperative risk factors for poor outcomes in patients with resectable invasive intraductal papillary mucinous carcinoma.
Databáze: OpenAIRE
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