{"title":"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。","authors":"Michinori Matsumoto, Masashi Tsunematsu, Ryoga Hamura, Koichiro Haruki, Kenei Furukawa, Yoshihiro Shirai, Tadashi Uwagawa, Shinji Onda, Tomohiko Taniai, Yoshiaki Tanji, Mitsuru Yanagaki, Toru Ikegami","doi":"10.1007/s00595-025-03050-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To identify the prognostic factors that can define biologically borderline resectable pancreatic cancer (BRPC) in resectable pancreatic cancer (RPC) patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sub>min</sub>) ≤ 1020 × 10<sup>-6</sup> mm<sup>2</sup>/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.</p><p><strong>Conclusions: </strong>Preoperative ADC<sub>min</sub> in RPC may be a new prognostic factor for biological BRPC.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":"1461-1470"},"PeriodicalIF":1.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Michinori Matsumoto, Masashi Tsunematsu, Ryoga Hamura, Koichiro Haruki, Kenei Furukawa, Yoshihiro Shirai, Tadashi Uwagawa, Shinji Onda, Tomohiko Taniai, Yoshiaki Tanji, Mitsuru Yanagaki, Toru Ikegami\",\"doi\":\"10.1007/s00595-025-03050-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To identify the prognostic factors that can define biologically borderline resectable pancreatic cancer (BRPC) in resectable pancreatic cancer (RPC) patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<sub>min</sub>) ≤ 1020 × 10<sup>-6</sup> mm<sup>2</sup>/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.</p><p><strong>Conclusions: </strong>Preoperative ADC<sub>min</sub> in RPC may be a new prognostic factor for biological BRPC.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":\" \",\"pages\":\"1461-1470\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-025-03050-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03050-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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.
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 (ADCmin) ≤ 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 ADCmin in RPC may be a new prognostic factor for biological BRPC.
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.
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