The minimum apparent diffusion coefficient value on preoperative magnetic resonance imaging in resectable pancreatic cancer: a new prognostic factor for biologically borderline resectable pancreatic cancer.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-10-01 Epub Date: 2025-04-29 DOI:10.1007/s00595-025-03050-w

Michinori Matsumoto, Masashi Tsunematsu, Ryoga Hamura, Koichiro Haruki, Kenei Furukawa, Yoshihiro Shirai, Tadashi Uwagawa, Shinji Onda, Tomohiko Taniai, Yoshiaki Tanji, Mitsuru Yanagaki, Toru Ikegami

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引用次数: 0

Abstract

Purpose: To identify the prognostic factors that can define biologically borderline resectable pancreatic cancer (BRPC) in resectable pancreatic cancer (RPC) patients.

Methods: This retrospective study included 121 R/BRPC patients who underwent upfront surgery. Univariate and multivariate analyses were conducted to investigate the relationship between preoperative factors and overall survival (OS) for RPC. The OS of RPC patients was stratified based on a score, with each independent prognostic factor receiving 1 point. The OS of the R/BRPC patients was compared based on their scores.

Results: Overall, 113 and eight patients had RPC and BRPC. Serum CA19-9 > 500 U/mL (p = 0.048), maximum tumor diameter > 30 mm (p = 0.01), superior mesenteric/portal vein contact < 180° (p = 0.04), and minimum apparent diffusion coefficient (ADC_min) ≤ 1020 × 10^-6 mm²/s (p = 0.01) were identified as independent prognostic factors in RPC patients. RPC patients with a score of 0 had a significantly better prognosis than those with scores of 1 and 2-4 and BRPC patients (median OS: 99.3, 35.1, 19.0, and 8.4 months; p = 0.007, p < 0.001, and p = 0.003, respectively). No significant difference in the prognosis was observed between BRPC and RPC patients with scores of 1 and 2-4.

Conclusions: Preoperative ADC_min in RPC may be a new prognostic factor for biological BRPC.

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可切除胰腺癌术前磁共振成像最小表观扩散系数值：生物学临界可切除胰腺癌的新预后因素。

目的：探讨可切除胰腺癌（RPC）患者生物学上边缘性可切除胰腺癌（BRPC）的预后因素。方法：本回顾性研究纳入121例接受前期手术的R/BRPC患者。进行单因素和多因素分析，探讨术前因素与RPC总生存期（OS）的关系。根据评分对RPC患者的OS进行分层，每个独立预后因素取1分。根据评分比较R/BRPC患者的OS。结果：RPC合并BRPC分别为113例和8例。血清CA19-9 > 500 U/mL （p = 0.048）、最大肿瘤直径> 30 mm （p = 0.01）、肠系膜上/门静脉接触分钟(min)≤1020 × 10-6 mm2/s （p = 0.01）是RPC患者预后的独立因素。评分为0分的RPC患者预后明显好于评分为1分、2-4分和BRPC患者(中位OS: 99.3、35.1、19.0和8.4个月；结论：RPC术前ADCmin可能是生物BRPC预后的新因素。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.