A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?

Nakamura Toru; Asano Toshimichi; Okamura Keisuke; Tsuchikawa Takahiro; Murakami Soichi; Kurashima Yo; Ebihara Yuma; Noji Takehiro; Nakanishi Yoshitsugu; Tanaka Kimitaka; Shichinohe Toshiaki; Hirano Satoshi

タイトル	en A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?
作成者	en Nakamura, Toru NRID 1000070645796 en Asano, Toshimichi en Okamura, Keisuke NRID 1000090724401 en Tsuchikawa, Takahiro NRID 1000050507572 en Murakami, Soichi NRID 1000080706573 en Kurashima, Yo NRID 1000040374350 en Ebihara, Yuma NRID 1000050632981 en Noji, Takehiro NRID 1000010739296 en Nakanishi, Yoshitsugu NRID 1000040447058 en Tanaka, Kimitaka en Shichinohe, Toshiaki NRID 1000070374353 en Hirano, Satoshi NRID 1000050322813
アクセス権	open access
権利情報	en The final publication is available at Springer via http://dx.doi.org/10.1007/s11605-018-3972-x
主題	Other en Resectable pancreatic cancer Other en Preoperative prognostic scoring Other en Upfront surgery NDC 490
内容注記	Abstract en Background: Upfront surgery is recommended in patients with potentially resectable pancreatic ductal adenocarcinoma (R-PDAC) by National Comprehensive Center Network (NCCN) guidelines. However, even among R-PDACs, there is a subset that demonstrates extremely poor prognosis. The purpose of this study was to identify preoperative prognostic factors for upfront surgical resection of R-PDACs. Methods: The records of 278 consecutive patients with PDAC who underwent curative resection between 2001 and 2015 in a single institution were retrospectively reviewed. Preoperative factors to predict prognosis in patients with R-PDAC according to the NCCN guidelines were analyzed. Results: Of the 278 patients who underwent resection, 153 R-PDACs received upfront surgery with a median survival time (MST) of 26.4months. Tumor location (pancreatic head) (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.14-3.40; P=0.015), preoperative cancer antigen 19-9 (CA19-9) >100U/mL (OR 1.92, 1.31-2.80; P=0.0009), and tumor size >20mm (OR 1.50, 1.02-2.19; P=0.038) were identified as preoperative independent predictive risk factors for poor prognosis in patients with R-PDACs. In the patients with R-PDAC, 5-year survival was 60.7%, 21.5%, and 0% in patients with 0, 1 or 2, and 3 risk factors, respectively. There were significant differences in overall survival between the three groups (P<.0001). Conclusions: A preoperative prognostic scoring system using preoperative tumor location, tumor size, and CA19-9 enables preoperative prediction of prognosis and facilitates selection of appropriate treatment for resectable pancreatic cancer.
出版者	en Springer
日付	Issued2019-05
言語	eng
資源タイプ	journal article
出版タイプ	AM
資源識別子	HDL http://hdl.handle.net/2115/77807
関連	isVersionOf DOI https://doi.org/10.1007/s11605-018-3972-x PMID 30242645
収録誌情報	PISSN 1091-255X en Journal of gastrointestinal surgery 巻23 号5 開始ページ990 終了ページ996
ファイル	fulltext JGSU_23_990.pdf 255.41 KB (application/pdf) Issued2019-05 fulltext Supplemental Figure 1 fine.pptx 56.93 KB (application/vnd.openxmlformats-officedocument.presentationml.presentation) Issued2019-05
コンテンツ更新日時	2023-07-26