Predictive factors of actual 5-y recurrence-free survival after upfront surgery for resectable pancreatic cancer

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Masao Uemura, Teiichi Sugiura, Ryo Ashida, Katsuhisa Ohgi, Mihoko Yamada, Shimpei Otsuka, Takeshi Aramaki, Akifumi Notsu, Katsuhiko Uesaka
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引用次数: 0

Abstract

Aim

The present study investigated the prognostic factors associated with actual 5-y recurrence-free survival (RFS) after upfront surgery for resectable pancreatic cancer (R-PC) in patients who were deemed not to require neoadjuvant treatment.

Methods

Between 2007 and 2016, 316 patients who underwent pancreatectomy for radiologically R-PC were retrospectively reviewed to evaluate the predictors of actual 5-y RFS. Predictors were identified using logistic regression analysis of preoperative evaluable factors. The cutoff values for continuous variables were determined based on a minimum p-value approach (model 1) or the value that maximized the rate of 5-y RFS survivors (model 2).

Results

Fifty-one patients (16.1%) achieved a 5-y RFS. A tumor size ≤23 mm, the absence of serosal invasion on computed tomography (CT), and Neutrophil-to-Lymphocyte Ratio <1.0, were significantly associated with the 5-y RFS in model 1. A Prognostic Nutritional Index ≥58 and the absence of serosal invasion and extrapancreatic nerve plexus invasion on CT were significantly associated with 5-y RFS in model 2. Only six (11.8%, model 1) and four (7.8%, model 2) patients had all three prognostic factors, and their 5-y RFS rates were 83.3% and 100%, respectively.

Conclusions

A modest number of patients who underwent upfront surgery achieved 5-y RFS, but only ~10% of them could be identified preoperatively. Based on these results, almost all R-PC patients are forced to undergo neoadjuvant treatment in daily practice.

Abstract Image

可切除胰腺癌前期手术后实际 5 年无复发生存期的预测因素
本研究调查了被认为不需要新辅助治疗的可切除胰腺癌(R-PC)患者前期手术后实际5年无复发生存期(RFS)的相关预后因素。2007年至2016年期间,对316例因放射学检查为R-PC而接受胰腺切除术的患者进行了回顾性研究,以评估实际5年RFS的预测因素。通过对术前可评估因素进行逻辑回归分析,确定了预测因素。连续变量的临界值根据最小 p 值法(模型 1)或最大化 5 年 RFS 存活率的值(模型 2)确定。在模型1中,肿瘤大小≤23毫米、计算机断层扫描(CT)显示无浆膜侵犯以及中性粒细胞与淋巴细胞比值<1.0与5年RFS显著相关。在模型2中,预后营养指数≥58和CT无浆膜侵犯及胰腺外神经丛侵犯与5年RFS显著相关。只有 6 例(11.8%,模型 1)和 4 例(7.8%,模型 2)患者同时具备这三个预后因素,他们的 5 年 RFS 率分别为 83.3% 和 100% 。基于这些结果,在日常实践中,几乎所有的 R-PC 患者都不得不接受新辅助治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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