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

Title	en A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?
Creator	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
Accessrights	open access
Rights	en The final publication is available at Springer via http://dx.doi.org/10.1007/s11605-018-3972-x
Subject	Other en Resectable pancreatic cancer Other en Preoperative prognostic scoring Other en Upfront surgery NDC 490
Description	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.
Publisher	en Springer
Date	Issued2019-05
Language	eng
Resource Type	journal article
Version Type	AM
Identifier	HDL http://hdl.handle.net/2115/77807
Relation	isVersionOf DOI https://doi.org/10.1007/s11605-018-3972-x PMID 30242645
Journal	PISSN 1091-255X en Journal of gastrointestinal surgery Volume Number23 Issue Number5 Page Start990 Page End996
File	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
Oaidate	2023-07-26