伴发或先发导管内乳头状粘液瘤不是切除胰腺癌的预后因素。

IF 2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of gastrointestinal oncology Pub Date : 2024-08-31 Epub Date: 2024-07-29 DOI:10.21037/jgo-24-157

Pedro Luiz Serrano Uson Junior, Ana Luiza Spina Nagy, Igor Wanderley Reis Dias, Marcelo Bruno de Rezende, Roberto Pestana, Diogo Bugano, Francisco Tustumi, Guilherme Naccache Namur, Jaime Arthur Pirola Kruger, Alberto Goldenberg, Sergio Eduardo Alonso Araujo, Nam Jin Kim, Sidney Klajner, Mitesh Borad, Fernando Moura

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引用次数: 0

摘要

背景：导管内乳头状粘液瘤（IPMN）相关性胰腺癌正成为切除标本中常见的胰腺癌亚型。该亚型的预后仍在评估中。本研究旨在评估与传统胰腺癌相比，IPMN相关胰腺癌的预后：本研究分析了2016年1月至2020年12月期间在以色列阿尔伯特-爱因斯坦医院接受治疗的切除胰腺肿瘤和IPMN患者。采用卡普兰-梅耶法估算总生存期（OS），并通过多变量分析评估相关变量与疾病特异性OS之间的相关性：在187名接受胰腺腺癌或IPMN切除术的患者中，125人（67%）患有胰腺腺癌，33人（18%）患有IPMN相关性胰腺腺癌，29人（16%）患有IPMN。切除的 IPMN 与大多数患者的长期 OS 有关。在这项研究中，与 IPMN 相关或不相关的前期切除胰腺癌的 OS 相似。切除的胰腺腺癌与IPMN相关的胰腺腺癌的中位OS无统计学差异（48个月对44个月，P=0.44）。肿瘤大小[危险比（HR），1.33]、切除III期（HR，1.31）、神经周围侵犯（HR，1.58）、淋巴管侵犯（HR，1.44）、淋巴结阳性（HR，1.34）和新辅助治疗（HR，1.70）与较差的预后有关：我们的研究结果证实，切除的胰腺癌预后较差，IPMN相关的胰腺腺癌与传统的胰腺腺癌预后相同。半数以上的 IPMN 相关腺癌病例已有阳性淋巴结。新辅助治疗对这类患者的影响应在更大的群体中进行研究。

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Concomitant or antecedent intraductal papillary mucinous neoplasm is not a prognostic factor in resected pancreatic cancer.

Background: Intraductal papillary mucinous neoplasm (IPMN)-associated pancreatic cancer is becoming a common subtype of pancreatic cancer found in resected specimens. The prognostic of this subtype is still under evaluation. The study aims to evaluate the prognosis of IPMN-associated pancreatic adenocarcinoma compared to the conventional pancreatic adenocarcinoma.

Methods: In this study, patients with resected pancreatic neoplasms and IPMN treated at Hospital Israelita Albert Einstein, from January 2016 to December 2020, were analyzed. Overall survival (OS) was estimated using the Kaplan-Meier method, and correlations between the variables of interest and the disease specific OS was assessed by multivariate analysis.

Results: Of 187 patients undergoing resection for pancreatic adenocarcinoma or IPMN, 125 (67%) had pancreatic adenocarcinoma, 33 (18%) had IPMN-associated pancreatic adenocarcinoma, and 29 (16%) had IPMN. Resected IPMN was associated with long-term OS for most of the patients. Similar OS was identified in this study in upfront resected pancreatic cancer associated or not with IPMN. No statistical differences in median OS were identified between resected pancreatic adenocarcinoma and IPMN-associated pancreatic adenocarcinoma (48 vs. 44 months, P=0.44). Size of the tumor [hazard ratio (HR), 1.33], resected stage III (HR, 1.31), perineural invasion (HR, 1.58), lymphovascular invasion (HR, 1.44), positive lymph nodes (HR, 1.34), and neoadjuvant treatment (HR, 1.70) were associated with worse outcomes.

Conclusions: Our findings confirm that resected pancreatic cancer has a poor prognosis and IPMN-associated pancreatic adenocarcinoma has the same prognosis as a conventional pancreatic adenocarcinoma. More than half of the cases of IPMN-associated adenocarcinoma already had positive lymph nodes. The impact of neoadjuvant treatment in this group of patients should be investigated in larger cohorts.

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来源期刊

Journal of gastrointestinal oncology Medicine-Oncology

CiteScore

3.20

自引率

0.00%

发文量

171

期刊介绍： ournal of Gastrointestinal Oncology (Print ISSN 2078-6891; Online ISSN 2219-679X; J Gastrointest Oncol; JGO), the official journal of Society for Gastrointestinal Oncology (SGO), is an open-access, international peer-reviewed journal. It is published quarterly (Sep. 2010- Dec. 2013), bimonthly (Feb. 2014 -) and openly distributed worldwide. JGO publishes manuscripts that focus on updated and practical information about diagnosis, prevention and clinical investigations of gastrointestinal cancer treatment. Specific areas of interest include, but not limited to, multimodality therapy, markers, imaging and tumor biology.