一项多中心国家队列研究显示,在特定条件下,胰腺癌伴同步肝少转移患者通过切除获得了显著的长期生存益处。

IF 2.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Kohei Nakata, Yoshihiro Miyasaka, Takeaki Ishizawa, Masayuki Ohtsuka, Masamichi Mizuma, Sohei Satoi, Masaaki Hidaka, Shuji Suzuki, Hiroshi Kurahara, Chie Kitami, Satoshi Hirano, Dongha Lee, Saiho Ko, Munenori Tahara, Isaku Yoshioka, Kenjiro Date, Kazuyuki Nagai, Goro Honda, Shugo Mizuno, Kenichi Hakamada, Yasuro Futagawa, Shigeru Marubashi, Hiroshi Yoshida, Akihiko Horiguchi, Yasuo Hosouchi, Masafumi Imamura, Naoto Gotohda, Hiroaki Nagano, Masaji Tani, Takeshi Sudo, Teijiro Hirashita, Junichi Arita, Katsutoshi Murase, Ken Fukumitsu, Toshiki Rikiyama, Teruyuki Usuba, Toshiya Abe, Masafumi Nakamura, Itaru Endo
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引用次数: 0

摘要

背景:在本研究中,我们研究了预测胰腺癌伴肝少转移患者手术切除后长期生存获益的标准。方法:在2005年至2020年期间,共纳入了来自日本34个大容量中心的60例肝少转移手术切除患者。采用单因素和多因素生存分析方法。所有患者均随访至少36个月。结果:术前化疗组总生存期(OS)明显长于术前手术组(37.4个月vs. 20.4个月,p = 0.001)。手术加术前化疗组,完全缓解8例(28.6%)。1年、3年和5年OS分别为92.9%、50.0%和35.7%。多因素分析显示低CA19-9(结论:术前化疗对肝少转移瘤的治疗至关重要。尽管复发率高,但符合特定标准的患者行肝切除术预后良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Patients With Pancreatic Cancer With Synchronous Liver Oligometastasis Show a Significant Long-Term Survival Benefit From Resection Under Specific Conditions: A Multicenter National Cohort Study

Patients With Pancreatic Cancer With Synchronous Liver Oligometastasis Show a Significant Long-Term Survival Benefit From Resection Under Specific Conditions: A Multicenter National Cohort Study

Background

In this study, we investigated the criteria that predict the long-term survival benefits after surgical resection in patients with pancreatic cancer accompanied by liver oligometastasis.

Methods

In total, 60 patients from 34 high-volume Japanese centers who underwent surgical resection for liver oligometastasis between 2005 and 2020 were included. Univariate and multivariate methods of survival analyses were performed. All patients were followed up for at least 36 months.

Results

Overall survival (OS) was significantly longer in the preoperative chemotherapy group than in the up-front surgery group (37.4 vs. 20.4 months, p = 0.001). In the operation with preoperative chemotherapy group, a complete response was observed in eight patients (28.6%). The 1-, 3-, and 5-year OS rates were 92.9%, 50.0%, and 35.7%, respectively. The multivariate analysis showed that low CA19-9 (< 100 U/mL; HR: 0.25; 95% CI: 0.06–0.96; p = 0.043), low CEA (< 5 U/mL; HR: 0.14; 95% CI: 0.04–0.48; p = 0.002), and resectable (R) or borderline resectable pancreatic cancer invading the portal vein (BR-PV) status (HR: 0.19; 95% CI: 0.07–0.51; p < 0.001) were positive prognostic factors. The median OS of the patients who met all three criteria was 106.6 months.

Conclusion

Preoperative chemotherapy is essential for the treatment of liver oligometastases. Despite the high recurrence rates, patients who met the specific criteria have a favorable prognosis with liver resection.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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