Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection
Background Pancreatic ductal adenocarcinomas (PDACs) are sometimes diagnosed accompanied by rapidly impaired diabetes (PDAC-RID). Although this type of PDAC may have unusual biological features, these features have not been explained. Methods Patients with PDAC who underwent upfront pancreatectomy b...
Gespeichert in:
| Veröffentlicht in: | Annals of surgical oncology 2024, Vol.31 (1), p.514-524 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 524 |
|---|---|
| container_issue | 1 |
| container_start_page | 514 |
| container_title | Annals of surgical oncology |
| container_volume | 31 |
| creator | Kiritani, Sho Ono, Yoshihiro Takamatsu, Manabu Yoshio, Sachiyo Miyashita, Mamiko Oba, Atsushi Sato, Takafumi Ito, Hiromichi Inoue, Yosuke Saiura, Akio Takahashi, Yu |
| description | Background
Pancreatic ductal adenocarcinomas (PDACs) are sometimes diagnosed accompanied by rapidly impaired diabetes (PDAC-RID). Although this type of PDAC may have unusual biological features, these features have not been explained.
Methods
Patients with PDAC who underwent upfront pancreatectomy between 2010 and 2018 were retrospectively reviewed. PDAC-RID was defined as a glycated hemoglobin (HbA1c) value of ≥ 8.0% of newly diagnosed diabetes, and acute exacerbation of previously diagnosed diabetes. Other patients were classified as PDAC with stable glycometabolism (PDAC-SG). Clinicopathological factors, long-term survival rates, and recurrence patterns were evaluated.
Results
Of the 520 enrolled patients, 104 were classified as PDAC-RID and 416 as PDAC-SG. There was no significant difference regarding TNM staging, resectability, or adjuvant chemotherapy rate between the groups. However, 5-years cancer-specific survival (CSS) was significantly higher in the PDAC-RID group than in the PDAC-SG group (45.3% vs. 31.1%;
p =
0.02). This survival difference was highlighted in relatively early-stage PDAC (≤ pT2N1) (CSS: 60.8% vs. 43.6%;
p =
0.01), but the difference was not significant for advanced-stage PDAC. A multivariate analysis of early-stage PDAC showed that PDAC-SG was an independent risk factor of shorter CSS (hazard ratio 1.76;
p =
0.02). The hematogenous metastatic rate in early-stage PDAC was lower in the PDAC-RID group than in the PDAC-SG group (18.3% vs. 35.8%;
p =
0.01).
Conclusions
PDAC-RID showed a favorable long-term survival rate after curative resection with low hematogenous metastases, which may be due to its unique biology. |
| doi_str_mv | 10.1245/s10434-023-14408-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2874265808</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2897519600</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-b5a7cba77d766f09c418d76d34e7c24dc6b61f76e12b887770c8f9d8232549a93</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0Eoj_wAiyQJTZsQv0X22E3nXag0kig0q4tx7kZuUrswU4GzZv0cesyhUosWPnq-LvnXt2D0DtKPlEm6rNMieCiIoxXVAiiK_ICHdO6SEJq-rLUROqqYbI-Qic53xFCFSf1a3TElSac6OYY3d8G_3MGfO7jEDd7HHv83QaXwE7e4YvZTXbAiw5CdDY5H-Jo8cK5OG5t8NDhdo-v7dZ3wx5fFc2nol1428IE-TNe4JXdxWTbAfA6hk11A2nEP-a087viu4rDEH_5sMHLOZWBO8DXkMFNPoY36FVvhwxvn95TdLu6vFl-rdbfvlwtF-vKcSanqq2tcq1VqlNS9qRxgupSdlyAckx0TraS9koCZa3WSinidN90mnFWi8Y2_BR9PPhuUyyHyJMZfXYwDDZAnLNhWolyQU10QT_8g97FOYWyXaEaVdNGElIodqBcijkn6M02-dGmvaHEPOZmDrmZkpv5nZt5bHr_ZD23I3R_W_4EVQB-AHL5ChtIz7P_Y_sACF2kGQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2897519600</pqid></control><display><type>article</type><title>Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Kiritani, Sho ; Ono, Yoshihiro ; Takamatsu, Manabu ; Yoshio, Sachiyo ; Miyashita, Mamiko ; Oba, Atsushi ; Sato, Takafumi ; Ito, Hiromichi ; Inoue, Yosuke ; Saiura, Akio ; Takahashi, Yu</creator><creatorcontrib>Kiritani, Sho ; Ono, Yoshihiro ; Takamatsu, Manabu ; Yoshio, Sachiyo ; Miyashita, Mamiko ; Oba, Atsushi ; Sato, Takafumi ; Ito, Hiromichi ; Inoue, Yosuke ; Saiura, Akio ; Takahashi, Yu</creatorcontrib><description>Background
Pancreatic ductal adenocarcinomas (PDACs) are sometimes diagnosed accompanied by rapidly impaired diabetes (PDAC-RID). Although this type of PDAC may have unusual biological features, these features have not been explained.
Methods
Patients with PDAC who underwent upfront pancreatectomy between 2010 and 2018 were retrospectively reviewed. PDAC-RID was defined as a glycated hemoglobin (HbA1c) value of ≥ 8.0% of newly diagnosed diabetes, and acute exacerbation of previously diagnosed diabetes. Other patients were classified as PDAC with stable glycometabolism (PDAC-SG). Clinicopathological factors, long-term survival rates, and recurrence patterns were evaluated.
Results
Of the 520 enrolled patients, 104 were classified as PDAC-RID and 416 as PDAC-SG. There was no significant difference regarding TNM staging, resectability, or adjuvant chemotherapy rate between the groups. However, 5-years cancer-specific survival (CSS) was significantly higher in the PDAC-RID group than in the PDAC-SG group (45.3% vs. 31.1%;
p =
0.02). This survival difference was highlighted in relatively early-stage PDAC (≤ pT2N1) (CSS: 60.8% vs. 43.6%;
p =
0.01), but the difference was not significant for advanced-stage PDAC. A multivariate analysis of early-stage PDAC showed that PDAC-SG was an independent risk factor of shorter CSS (hazard ratio 1.76;
p =
0.02). The hematogenous metastatic rate in early-stage PDAC was lower in the PDAC-RID group than in the PDAC-SG group (18.3% vs. 35.8%;
p =
0.01).
Conclusions
PDAC-RID showed a favorable long-term survival rate after curative resection with low hematogenous metastases, which may be due to its unique biology.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-023-14408-0</identifier><identifier>PMID: 37803089</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adenocarcinoma ; Biology ; Carcinoma, Pancreatic Ductal - complications ; Carcinoma, Pancreatic Ductal - surgery ; Chemotherapy ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - surgery ; Hemoglobin ; Humans ; Medicine ; Medicine & Public Health ; Metastases ; Multivariate analysis ; Oncology ; Pancreas ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms ; Pancreatic Neoplasms - pathology ; Pancreatic Tumors ; Prognosis ; Retrospective Studies ; Risk factors ; Surgery ; Surgical Oncology ; Survival ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2024, Vol.31 (1), p.514-524</ispartof><rights>Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Society of Surgical Oncology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-b5a7cba77d766f09c418d76d34e7c24dc6b61f76e12b887770c8f9d8232549a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-023-14408-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-023-14408-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37803089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiritani, Sho</creatorcontrib><creatorcontrib>Ono, Yoshihiro</creatorcontrib><creatorcontrib>Takamatsu, Manabu</creatorcontrib><creatorcontrib>Yoshio, Sachiyo</creatorcontrib><creatorcontrib>Miyashita, Mamiko</creatorcontrib><creatorcontrib>Oba, Atsushi</creatorcontrib><creatorcontrib>Sato, Takafumi</creatorcontrib><creatorcontrib>Ito, Hiromichi</creatorcontrib><creatorcontrib>Inoue, Yosuke</creatorcontrib><creatorcontrib>Saiura, Akio</creatorcontrib><creatorcontrib>Takahashi, Yu</creatorcontrib><title>Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Pancreatic ductal adenocarcinomas (PDACs) are sometimes diagnosed accompanied by rapidly impaired diabetes (PDAC-RID). Although this type of PDAC may have unusual biological features, these features have not been explained.
Methods
Patients with PDAC who underwent upfront pancreatectomy between 2010 and 2018 were retrospectively reviewed. PDAC-RID was defined as a glycated hemoglobin (HbA1c) value of ≥ 8.0% of newly diagnosed diabetes, and acute exacerbation of previously diagnosed diabetes. Other patients were classified as PDAC with stable glycometabolism (PDAC-SG). Clinicopathological factors, long-term survival rates, and recurrence patterns were evaluated.
Results
Of the 520 enrolled patients, 104 were classified as PDAC-RID and 416 as PDAC-SG. There was no significant difference regarding TNM staging, resectability, or adjuvant chemotherapy rate between the groups. However, 5-years cancer-specific survival (CSS) was significantly higher in the PDAC-RID group than in the PDAC-SG group (45.3% vs. 31.1%;
p =
0.02). This survival difference was highlighted in relatively early-stage PDAC (≤ pT2N1) (CSS: 60.8% vs. 43.6%;
p =
0.01), but the difference was not significant for advanced-stage PDAC. A multivariate analysis of early-stage PDAC showed that PDAC-SG was an independent risk factor of shorter CSS (hazard ratio 1.76;
p =
0.02). The hematogenous metastatic rate in early-stage PDAC was lower in the PDAC-RID group than in the PDAC-SG group (18.3% vs. 35.8%;
p =
0.01).
Conclusions
PDAC-RID showed a favorable long-term survival rate after curative resection with low hematogenous metastases, which may be due to its unique biology.</description><subject>Adenocarcinoma</subject><subject>Biology</subject><subject>Carcinoma, Pancreatic Ductal - complications</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Chemotherapy</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - surgery</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Multivariate analysis</subject><subject>Oncology</subject><subject>Pancreas</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Tumors</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1u1DAUhS0Eoj_wAiyQJTZsQv0X22E3nXag0kig0q4tx7kZuUrswU4GzZv0cesyhUosWPnq-LvnXt2D0DtKPlEm6rNMieCiIoxXVAiiK_ICHdO6SEJq-rLUROqqYbI-Qic53xFCFSf1a3TElSac6OYY3d8G_3MGfO7jEDd7HHv83QaXwE7e4YvZTXbAiw5CdDY5H-Jo8cK5OG5t8NDhdo-v7dZ3wx5fFc2nol1428IE-TNe4JXdxWTbAfA6hk11A2nEP-a087viu4rDEH_5sMHLOZWBO8DXkMFNPoY36FVvhwxvn95TdLu6vFl-rdbfvlwtF-vKcSanqq2tcq1VqlNS9qRxgupSdlyAckx0TraS9koCZa3WSinidN90mnFWi8Y2_BR9PPhuUyyHyJMZfXYwDDZAnLNhWolyQU10QT_8g97FOYWyXaEaVdNGElIodqBcijkn6M02-dGmvaHEPOZmDrmZkpv5nZt5bHr_ZD23I3R_W_4EVQB-AHL5ChtIz7P_Y_sACF2kGQ</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Kiritani, Sho</creator><creator>Ono, Yoshihiro</creator><creator>Takamatsu, Manabu</creator><creator>Yoshio, Sachiyo</creator><creator>Miyashita, Mamiko</creator><creator>Oba, Atsushi</creator><creator>Sato, Takafumi</creator><creator>Ito, Hiromichi</creator><creator>Inoue, Yosuke</creator><creator>Saiura, Akio</creator><creator>Takahashi, Yu</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>2024</creationdate><title>Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection</title><author>Kiritani, Sho ; Ono, Yoshihiro ; Takamatsu, Manabu ; Yoshio, Sachiyo ; Miyashita, Mamiko ; Oba, Atsushi ; Sato, Takafumi ; Ito, Hiromichi ; Inoue, Yosuke ; Saiura, Akio ; Takahashi, Yu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-b5a7cba77d766f09c418d76d34e7c24dc6b61f76e12b887770c8f9d8232549a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenocarcinoma</topic><topic>Biology</topic><topic>Carcinoma, Pancreatic Ductal - complications</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Chemotherapy</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - surgery</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Multivariate analysis</topic><topic>Oncology</topic><topic>Pancreas</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Tumors</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiritani, Sho</creatorcontrib><creatorcontrib>Ono, Yoshihiro</creatorcontrib><creatorcontrib>Takamatsu, Manabu</creatorcontrib><creatorcontrib>Yoshio, Sachiyo</creatorcontrib><creatorcontrib>Miyashita, Mamiko</creatorcontrib><creatorcontrib>Oba, Atsushi</creatorcontrib><creatorcontrib>Sato, Takafumi</creatorcontrib><creatorcontrib>Ito, Hiromichi</creatorcontrib><creatorcontrib>Inoue, Yosuke</creatorcontrib><creatorcontrib>Saiura, Akio</creatorcontrib><creatorcontrib>Takahashi, Yu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiritani, Sho</au><au>Ono, Yoshihiro</au><au>Takamatsu, Manabu</au><au>Yoshio, Sachiyo</au><au>Miyashita, Mamiko</au><au>Oba, Atsushi</au><au>Sato, Takafumi</au><au>Ito, Hiromichi</au><au>Inoue, Yosuke</au><au>Saiura, Akio</au><au>Takahashi, Yu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2024</date><risdate>2024</risdate><volume>31</volume><issue>1</issue><spage>514</spage><epage>524</epage><pages>514-524</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Pancreatic ductal adenocarcinomas (PDACs) are sometimes diagnosed accompanied by rapidly impaired diabetes (PDAC-RID). Although this type of PDAC may have unusual biological features, these features have not been explained.
Methods
Patients with PDAC who underwent upfront pancreatectomy between 2010 and 2018 were retrospectively reviewed. PDAC-RID was defined as a glycated hemoglobin (HbA1c) value of ≥ 8.0% of newly diagnosed diabetes, and acute exacerbation of previously diagnosed diabetes. Other patients were classified as PDAC with stable glycometabolism (PDAC-SG). Clinicopathological factors, long-term survival rates, and recurrence patterns were evaluated.
Results
Of the 520 enrolled patients, 104 were classified as PDAC-RID and 416 as PDAC-SG. There was no significant difference regarding TNM staging, resectability, or adjuvant chemotherapy rate between the groups. However, 5-years cancer-specific survival (CSS) was significantly higher in the PDAC-RID group than in the PDAC-SG group (45.3% vs. 31.1%;
p =
0.02). This survival difference was highlighted in relatively early-stage PDAC (≤ pT2N1) (CSS: 60.8% vs. 43.6%;
p =
0.01), but the difference was not significant for advanced-stage PDAC. A multivariate analysis of early-stage PDAC showed that PDAC-SG was an independent risk factor of shorter CSS (hazard ratio 1.76;
p =
0.02). The hematogenous metastatic rate in early-stage PDAC was lower in the PDAC-RID group than in the PDAC-SG group (18.3% vs. 35.8%;
p =
0.01).
Conclusions
PDAC-RID showed a favorable long-term survival rate after curative resection with low hematogenous metastases, which may be due to its unique biology.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37803089</pmid><doi>10.1245/s10434-023-14408-0</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2024, Vol.31 (1), p.514-524 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2874265808 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adenocarcinoma Biology Carcinoma, Pancreatic Ductal - complications Carcinoma, Pancreatic Ductal - surgery Chemotherapy Diabetes Diabetes mellitus Diabetes Mellitus - surgery Hemoglobin Humans Medicine Medicine & Public Health Metastases Multivariate analysis Oncology Pancreas Pancreatectomy Pancreatic cancer Pancreatic Neoplasms Pancreatic Neoplasms - pathology Pancreatic Tumors Prognosis Retrospective Studies Risk factors Surgery Surgical Oncology Survival Survival Rate |
| title | Unique Biology of Pancreatic Ductal Adenocarcinoma Accompanied by Rapidly Impaired Diabetes: A Favorable Long-Term Survival Following Curative Resection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T13%3A00%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Unique%20Biology%20of%20Pancreatic%20Ductal%20Adenocarcinoma%20Accompanied%20by%20Rapidly%20Impaired%20Diabetes:%20A%20Favorable%20Long-Term%20Survival%20Following%20Curative%20Resection&rft.jtitle=Annals%20of%20surgical%20oncology&rft.au=Kiritani,%20Sho&rft.date=2024&rft.volume=31&rft.issue=1&rft.spage=514&rft.epage=524&rft.pages=514-524&rft.issn=1068-9265&rft.eissn=1534-4681&rft_id=info:doi/10.1245/s10434-023-14408-0&rft_dat=%3Cproquest_cross%3E2897519600%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2897519600&rft_id=info:pmid/37803089&rfr_iscdi=true |