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 |
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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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