胰腺癌切除术后早期肝脏复发的危险因素。

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2024-12-02 DOI:10.1097/MPA.0000000000002441

Yoshihiro Shirai, Nana Kimura, Haruyoshi Tanaka, Mina Fukasawa, Ryo Muranushi, Toru Watanabe, Katsuhisa Hirano, Kazuto Shibuya, Isaku Yoshioka, Tsutomu Fujii

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引用次数: 0

摘要

背景：肝切除后复发是最常见的复发类型之一，也是预后不良的危险因素。本研究的目的是确定初始肝脏复发的危险因素。方法：选取2015 - 2022年间行胰腺导管腺癌切除术的109例患者。分析临床病理变量对肝脏复发的影响，建立预测肝脏复发的评分系统。结果：肝脏复发率为24%，1年内复发率为17%。肝脏复发患者1年内预后极差[MST 12.4 (95% CI 5.7-19.1)]。在多因素分析中，R-PV、肿瘤直径≥45 mm大和静脉侵犯是早期肝脏复发的独立危险因素。当这些危险因素分别评分为1分时，1年肝脏复发率分别为0（0%）、1（9%）、2（30%）和3（84%）。结论：R-PV、肿瘤直径≥45 mm、病理性静脉侵犯是术后早期肝脏复发的危险因素。有这些因素的胰腺癌手术可能需要特殊治疗，如肝动脉注射。

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Risk factors for early liver recurrence after pancreatic cancer resection.

Background: Liver recurrence after resection is one of the most common types of recurrence and is a risk factor for poor prognosis. The aim of this study was to identify risk factors for initial liver recurrence.

Methods: Total of 109 patients with resectable pancreatic ductal adenocarcinoma who underwent resection between 2015 and 2022 were included. The influence of clinicopathologic variables on liver recurrence was analyzed to create a novel scoring system to predict liver recurrence.

Results: The liver recurrence rate was 24%, with 17% recurrence within one year. Patients with liver recurrence had an extremely poor prognosis within 1 year [MST 12.4 (95% CI 5.7-19.1)]. In multivariate analysis, R-PV, large tumor diameter ≥ 45 mm and venous invasion were independent risk factors for early liver recurrence. When each of these risk factors was scored as 1 point, the 1-year liver recurrence rates by score were 0 (0%), 1 (9%), 2 (30%), and 3 (84%).

Conclusion: The risk factors for postoperative early liver recurrence were R-PV, a tumor diameter ≥ 45 mm and pathological venous invasion. Surgery for pancreatic cancer with these factors may require special treatment, such as hepatic arterial injection.

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.