Predictive factors for early recurrence after pancreaticoduodenectomy in patients with resectable pancreatic head cancer: A multicenter retrospective study
Patients diagnosed with resectable pancreatic ductal adenocarcinoma often experience early recurrence even after upfront R0 resection. This study aimed to define early recurrence and identify preoperative risk factors for early recurrence after upfront pancreaticoduodenectomy in patients with resect...
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| Veröffentlicht in: | Surgery 2022-12, Vol.172 (6), p.1782-1790 |
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| creator | Ono, Shinichiro Adachi, Tomohiko Ohtsuka, Takao Kimura, Ryuichiro Nishihara, Kazuyoshi Watanabe, Yusuke Nagano, Hiroaki Tokumitsu, Yukio Nanashima, Atsushi Imamura, Naoya Baba, Hideo Chikamoto, Akira Inomata, Masafumi Hirashita, Teijiro Furukawa, Masayuki Idichi, Tetsuya Shinchi, Hiroyuki Maruyama, Yuichiro Nakamura, Masafumi Eguchi, Susumu |
| description | Patients diagnosed with resectable pancreatic ductal adenocarcinoma often experience early recurrence even after upfront R0 resection. This study aimed to define early recurrence and identify preoperative risk factors for early recurrence after upfront pancreaticoduodenectomy in patients with resectable pancreatic ductal adenocarcinoma of the pancreatic head.
This multicenter, retrospective study involved 500 patients who underwent pancreaticoduodenectomy resectable pancreatic ductal adenocarcinoma of the pancreatic head at 10 institutions between 2007 and 2016. Preoperative, intraoperative, and postoperative clinicopathological results were compared between early and non-early recurrence groups. Predictors of early recurrence were determined using statistical analyses.
Log-rank tests revealed a significant difference (P < .001) between recurrence within 3 to 6 months and 6 to 9 months. Early recurrence was subsequently defined as recurrence within 6 months. Patients were categorized into early recurrence (n = 104) and non-early recurrence groups (n = 389). The median overall survival of the early and non-early recurrence groups was 8.6 months and 42.6 months (P < .001), respectively. Preoperatively, high carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion, and diabetes mellitus were identified as independent predictive risk factors for early recurrence according to multivariate analysis. Comparing survival rates among patients with 3, 2, 1, or none of these factors, the median overall survival was 17.6 (n = 90), 21.2 (n = 184), 47 (n = 141), and 61.5 (n = 73) months, respectively.
The optimal period that defines the early recurrence for resectable pancreatic ductal adenocarcinoma of the pancreatic head is 6 months. Tumor size ≥20 mm, preoperative carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion of the tumor, and the presence of diabetes mellitus are independently associated with early recurrence. |
| doi_str_mv | 10.1016/j.surg.2022.08.004 |
| format | Article |
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This multicenter, retrospective study involved 500 patients who underwent pancreaticoduodenectomy resectable pancreatic ductal adenocarcinoma of the pancreatic head at 10 institutions between 2007 and 2016. Preoperative, intraoperative, and postoperative clinicopathological results were compared between early and non-early recurrence groups. Predictors of early recurrence were determined using statistical analyses.
Log-rank tests revealed a significant difference (P < .001) between recurrence within 3 to 6 months and 6 to 9 months. Early recurrence was subsequently defined as recurrence within 6 months. Patients were categorized into early recurrence (n = 104) and non-early recurrence groups (n = 389). The median overall survival of the early and non-early recurrence groups was 8.6 months and 42.6 months (P < .001), respectively. Preoperatively, high carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion, and diabetes mellitus were identified as independent predictive risk factors for early recurrence according to multivariate analysis. Comparing survival rates among patients with 3, 2, 1, or none of these factors, the median overall survival was 17.6 (n = 90), 21.2 (n = 184), 47 (n = 141), and 61.5 (n = 73) months, respectively.
The optimal period that defines the early recurrence for resectable pancreatic ductal adenocarcinoma of the pancreatic head is 6 months. Tumor size ≥20 mm, preoperative carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion of the tumor, and the presence of diabetes mellitus are independently associated with early recurrence.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2022.08.004</identifier><identifier>PMID: 36123175</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - surgery ; CA-19-9 Antigen ; Carbohydrates ; Carcinoma, Pancreatic Ductal ; Humans ; Neoplasm Recurrence, Local - pathology ; Pancreatic Neoplasms ; Pancreaticoduodenectomy - methods ; Retrospective Studies</subject><ispartof>Surgery, 2022-12, Vol.172 (6), p.1782-1790</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-cd975ed7e0f625c9cf6d41f1a30d5d406ba65159bb98e15860d2fd2296e9679e3</citedby><cites>FETCH-LOGICAL-c356t-cd975ed7e0f625c9cf6d41f1a30d5d406ba65159bb98e15860d2fd2296e9679e3</cites><orcidid>0000-0002-6196-8643 ; 0000-0002-8358-5328 ; 0000-0001-8048-2203 ; 0000-0002-3489-3180 ; 0000-0001-9510-8660</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.surg.2022.08.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36123175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ono, Shinichiro</creatorcontrib><creatorcontrib>Adachi, Tomohiko</creatorcontrib><creatorcontrib>Ohtsuka, Takao</creatorcontrib><creatorcontrib>Kimura, Ryuichiro</creatorcontrib><creatorcontrib>Nishihara, Kazuyoshi</creatorcontrib><creatorcontrib>Watanabe, Yusuke</creatorcontrib><creatorcontrib>Nagano, Hiroaki</creatorcontrib><creatorcontrib>Tokumitsu, Yukio</creatorcontrib><creatorcontrib>Nanashima, Atsushi</creatorcontrib><creatorcontrib>Imamura, Naoya</creatorcontrib><creatorcontrib>Baba, Hideo</creatorcontrib><creatorcontrib>Chikamoto, Akira</creatorcontrib><creatorcontrib>Inomata, Masafumi</creatorcontrib><creatorcontrib>Hirashita, Teijiro</creatorcontrib><creatorcontrib>Furukawa, Masayuki</creatorcontrib><creatorcontrib>Idichi, Tetsuya</creatorcontrib><creatorcontrib>Shinchi, Hiroyuki</creatorcontrib><creatorcontrib>Maruyama, Yuichiro</creatorcontrib><creatorcontrib>Nakamura, Masafumi</creatorcontrib><creatorcontrib>Eguchi, Susumu</creatorcontrib><title>Predictive factors for early recurrence after pancreaticoduodenectomy in patients with resectable pancreatic head cancer: A multicenter retrospective study</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Patients diagnosed with resectable pancreatic ductal adenocarcinoma often experience early recurrence even after upfront R0 resection. This study aimed to define early recurrence and identify preoperative risk factors for early recurrence after upfront pancreaticoduodenectomy in patients with resectable pancreatic ductal adenocarcinoma of the pancreatic head.
This multicenter, retrospective study involved 500 patients who underwent pancreaticoduodenectomy resectable pancreatic ductal adenocarcinoma of the pancreatic head at 10 institutions between 2007 and 2016. Preoperative, intraoperative, and postoperative clinicopathological results were compared between early and non-early recurrence groups. Predictors of early recurrence were determined using statistical analyses.
Log-rank tests revealed a significant difference (P < .001) between recurrence within 3 to 6 months and 6 to 9 months. Early recurrence was subsequently defined as recurrence within 6 months. Patients were categorized into early recurrence (n = 104) and non-early recurrence groups (n = 389). The median overall survival of the early and non-early recurrence groups was 8.6 months and 42.6 months (P < .001), respectively. Preoperatively, high carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion, and diabetes mellitus were identified as independent predictive risk factors for early recurrence according to multivariate analysis. Comparing survival rates among patients with 3, 2, 1, or none of these factors, the median overall survival was 17.6 (n = 90), 21.2 (n = 184), 47 (n = 141), and 61.5 (n = 73) months, respectively.
The optimal period that defines the early recurrence for resectable pancreatic ductal adenocarcinoma of the pancreatic head is 6 months. Tumor size ≥20 mm, preoperative carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion of the tumor, and the presence of diabetes mellitus are independently associated with early recurrence.</description><subject>Adenocarcinoma - surgery</subject><subject>CA-19-9 Antigen</subject><subject>Carbohydrates</subject><subject>Carcinoma, Pancreatic Ductal</subject><subject>Humans</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>Retrospective Studies</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi1ERYfCC7BAXrJJOHbGToLYVBU3qRJdlLXl2MfUo1yGY6fVPAsvW4-mIFasLPu_6Bx_jL0RUAsQ-v2uTiv9rCVIWUNXA2yfsY1QjazaRovnbAPQ9JUGDefsZUo7AOi3onvBzossG9GqDft9Q-ijy_EeebAuL5R4WIijpfHACd1KhLNDbkNG4ns7O0Kbo1v8unicsUSmA49zkXLEOSf-EPNdSaYi2WHEfzL8Dq3nrtyRPvBLPq1jeS2h0kyYaUl7PI2S8uoPr9hZsGPC10_nBfvx-dPt1dfq-vuXb1eX15VrlM6V832r0LcIQUvlehe034ogbANe-S3owWolVD8MfYdCdRq8DF7KXmOv2x6bC_bu1Lun5deKKZspJofjaGdc1mRkKzR0rVKqWOXJ6sqwiTCYPcXJ0sEIMEcoZmeOUMwRioHOFCgl9Papfx0m9H8jfygUw8eTAcuW9xHJJBePv-5jIZCNX-L_-h8BH7mixw</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Ono, Shinichiro</creator><creator>Adachi, Tomohiko</creator><creator>Ohtsuka, Takao</creator><creator>Kimura, Ryuichiro</creator><creator>Nishihara, Kazuyoshi</creator><creator>Watanabe, Yusuke</creator><creator>Nagano, Hiroaki</creator><creator>Tokumitsu, Yukio</creator><creator>Nanashima, Atsushi</creator><creator>Imamura, Naoya</creator><creator>Baba, Hideo</creator><creator>Chikamoto, Akira</creator><creator>Inomata, Masafumi</creator><creator>Hirashita, Teijiro</creator><creator>Furukawa, Masayuki</creator><creator>Idichi, Tetsuya</creator><creator>Shinchi, Hiroyuki</creator><creator>Maruyama, Yuichiro</creator><creator>Nakamura, Masafumi</creator><creator>Eguchi, Susumu</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6196-8643</orcidid><orcidid>https://orcid.org/0000-0002-8358-5328</orcidid><orcidid>https://orcid.org/0000-0001-8048-2203</orcidid><orcidid>https://orcid.org/0000-0002-3489-3180</orcidid><orcidid>https://orcid.org/0000-0001-9510-8660</orcidid></search><sort><creationdate>202212</creationdate><title>Predictive factors for early recurrence after pancreaticoduodenectomy in patients with resectable pancreatic head cancer: A multicenter retrospective study</title><author>Ono, Shinichiro ; Adachi, Tomohiko ; Ohtsuka, Takao ; Kimura, Ryuichiro ; Nishihara, Kazuyoshi ; Watanabe, Yusuke ; Nagano, Hiroaki ; Tokumitsu, Yukio ; Nanashima, Atsushi ; Imamura, Naoya ; Baba, Hideo ; Chikamoto, Akira ; Inomata, Masafumi ; Hirashita, Teijiro ; Furukawa, Masayuki ; Idichi, Tetsuya ; Shinchi, Hiroyuki ; Maruyama, Yuichiro ; Nakamura, Masafumi ; Eguchi, Susumu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-cd975ed7e0f625c9cf6d41f1a30d5d406ba65159bb98e15860d2fd2296e9679e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adenocarcinoma - surgery</topic><topic>CA-19-9 Antigen</topic><topic>Carbohydrates</topic><topic>Carcinoma, Pancreatic Ductal</topic><topic>Humans</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Pancreatic Neoplasms</topic><topic>Pancreaticoduodenectomy - methods</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ono, Shinichiro</creatorcontrib><creatorcontrib>Adachi, Tomohiko</creatorcontrib><creatorcontrib>Ohtsuka, Takao</creatorcontrib><creatorcontrib>Kimura, Ryuichiro</creatorcontrib><creatorcontrib>Nishihara, Kazuyoshi</creatorcontrib><creatorcontrib>Watanabe, Yusuke</creatorcontrib><creatorcontrib>Nagano, Hiroaki</creatorcontrib><creatorcontrib>Tokumitsu, Yukio</creatorcontrib><creatorcontrib>Nanashima, Atsushi</creatorcontrib><creatorcontrib>Imamura, Naoya</creatorcontrib><creatorcontrib>Baba, Hideo</creatorcontrib><creatorcontrib>Chikamoto, Akira</creatorcontrib><creatorcontrib>Inomata, Masafumi</creatorcontrib><creatorcontrib>Hirashita, Teijiro</creatorcontrib><creatorcontrib>Furukawa, Masayuki</creatorcontrib><creatorcontrib>Idichi, Tetsuya</creatorcontrib><creatorcontrib>Shinchi, Hiroyuki</creatorcontrib><creatorcontrib>Maruyama, Yuichiro</creatorcontrib><creatorcontrib>Nakamura, Masafumi</creatorcontrib><creatorcontrib>Eguchi, Susumu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ono, Shinichiro</au><au>Adachi, Tomohiko</au><au>Ohtsuka, Takao</au><au>Kimura, Ryuichiro</au><au>Nishihara, Kazuyoshi</au><au>Watanabe, Yusuke</au><au>Nagano, Hiroaki</au><au>Tokumitsu, Yukio</au><au>Nanashima, Atsushi</au><au>Imamura, Naoya</au><au>Baba, Hideo</au><au>Chikamoto, Akira</au><au>Inomata, Masafumi</au><au>Hirashita, Teijiro</au><au>Furukawa, Masayuki</au><au>Idichi, Tetsuya</au><au>Shinchi, Hiroyuki</au><au>Maruyama, Yuichiro</au><au>Nakamura, Masafumi</au><au>Eguchi, Susumu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive factors for early recurrence after pancreaticoduodenectomy in patients with resectable pancreatic head cancer: A multicenter retrospective study</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2022-12</date><risdate>2022</risdate><volume>172</volume><issue>6</issue><spage>1782</spage><epage>1790</epage><pages>1782-1790</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Patients diagnosed with resectable pancreatic ductal adenocarcinoma often experience early recurrence even after upfront R0 resection. This study aimed to define early recurrence and identify preoperative risk factors for early recurrence after upfront pancreaticoduodenectomy in patients with resectable pancreatic ductal adenocarcinoma of the pancreatic head.
This multicenter, retrospective study involved 500 patients who underwent pancreaticoduodenectomy resectable pancreatic ductal adenocarcinoma of the pancreatic head at 10 institutions between 2007 and 2016. Preoperative, intraoperative, and postoperative clinicopathological results were compared between early and non-early recurrence groups. Predictors of early recurrence were determined using statistical analyses.
Log-rank tests revealed a significant difference (P < .001) between recurrence within 3 to 6 months and 6 to 9 months. Early recurrence was subsequently defined as recurrence within 6 months. Patients were categorized into early recurrence (n = 104) and non-early recurrence groups (n = 389). The median overall survival of the early and non-early recurrence groups was 8.6 months and 42.6 months (P < .001), respectively. Preoperatively, high carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion, and diabetes mellitus were identified as independent predictive risk factors for early recurrence according to multivariate analysis. Comparing survival rates among patients with 3, 2, 1, or none of these factors, the median overall survival was 17.6 (n = 90), 21.2 (n = 184), 47 (n = 141), and 61.5 (n = 73) months, respectively.
The optimal period that defines the early recurrence for resectable pancreatic ductal adenocarcinoma of the pancreatic head is 6 months. Tumor size ≥20 mm, preoperative carbohydrate antigen 19-9 levels ≥120 U/mL, retroperitoneal invasion of the tumor, and the presence of diabetes mellitus are independently associated with early recurrence.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36123175</pmid><doi>10.1016/j.surg.2022.08.004</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6196-8643</orcidid><orcidid>https://orcid.org/0000-0002-8358-5328</orcidid><orcidid>https://orcid.org/0000-0001-8048-2203</orcidid><orcidid>https://orcid.org/0000-0002-3489-3180</orcidid><orcidid>https://orcid.org/0000-0001-9510-8660</orcidid></addata></record> |
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| ispartof | Surgery, 2022-12, Vol.172 (6), p.1782-1790 |
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| subjects | Adenocarcinoma - surgery CA-19-9 Antigen Carbohydrates Carcinoma, Pancreatic Ductal Humans Neoplasm Recurrence, Local - pathology Pancreatic Neoplasms Pancreaticoduodenectomy - methods Retrospective Studies |
| title | Predictive factors for early recurrence after pancreaticoduodenectomy in patients with resectable pancreatic head cancer: A multicenter retrospective study |
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