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Clinical and pathological features of five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

Kimura K, Amano R, Nakata B, Yamazoe S, Hirata K, Murata A, Miura K, Nishio K, Hirakawa T, Ohira M, Hirakawa K - World J Surg Oncol (2014)

Bottom Line: Of 147 patients, 18 survived for more than five years after surgery without disease recurrence.A univariate analyses demonstrated that: two or fewer lymph node metastases (P=0.014), a preoperative serum carbohydrate antigen 19-9 (CA19-9) level of 40 U/mL or less (P=0.0018), an absence of intrapancreatic nerve invasion (P=0.028), and undergoing an R0 resection (P=0.011) were significantly associated with five-year survival.We conclude that number of lymph node metastases being two or less, a preoperative serum CA19-9 level of 40 U/mL or less, and undergoing an R0 resection may be independent predictive factors to identify actual five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. kenjiro@med.osaka-cu.ac.jp.

ABSTRACT

Background: Clinical factors determining short-term survival after pancreatectomy have been well studied, but factors predicting long-term survival with curative resection are poorly understood in pancreatic carcinoma. Our objective was to identify clinical and pathological features of five-year disease-free survivors after surgical resection of pancreatic adenocarcinoma.

Methods: The clinical and pathological data from 147 patients who underwent a potentially curative resection for pancreatic adenocarcinoma at our institution between 1988 and 2012 were retrospectively analyzed.

Results: Of 147 patients, 18 survived for more than five years after surgery without disease recurrence. A univariate analyses demonstrated that: two or fewer lymph node metastases (P=0.014), a preoperative serum carbohydrate antigen 19-9 (CA19-9) level of 40 U/mL or less (P=0.0018), an absence of intrapancreatic nerve invasion (P=0.028), and undergoing an R0 resection (P=0.011) were significantly associated with five-year survival. A logistic regression model identified the following independent cancer-related predictors of five-year survivors: having two or fewer lymph node metastases (odds ratio (OR): 6.02; 95% confidence interval (CI): 1.08 to 112.98; P=0.0385), a preoperative serum CA19-9 level of 40 U/mL or less (OR: 5.02; 95% CI: 1.68 to 16.48; P=0.0036), and undergoing an R0 resection (OR: 3.63; 95% CI: 1.12 to 14.28; P=0.0316).

Conclusions: We conclude that number of lymph node metastases being two or less, a preoperative serum CA19-9 level of 40 U/mL or less, and undergoing an R0 resection may be independent predictive factors to identify actual five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

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Receiver operating characteristic (ROC) curve analysis of preoperative CA19-9 for prediction of five-year survival of patients with pancreatic carcinoma An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point. The area under the curve (AUC) was 0.670.
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Fig1: Receiver operating characteristic (ROC) curve analysis of preoperative CA19-9 for prediction of five-year survival of patients with pancreatic carcinoma An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point. The area under the curve (AUC) was 0.670.

Mentions: The median preoperative serum CA19-9 level of the 147 patients was 122 U/mL. An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point for five-year survival, with a sensitivity of 66.7% and a specificity of 73.6%. The area under the curve (AUC) was 0.670 (FigureĀ 1).Table 1


Clinical and pathological features of five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

Kimura K, Amano R, Nakata B, Yamazoe S, Hirata K, Murata A, Miura K, Nishio K, Hirakawa T, Ohira M, Hirakawa K - World J Surg Oncol (2014)

Receiver operating characteristic (ROC) curve analysis of preoperative CA19-9 for prediction of five-year survival of patients with pancreatic carcinoma An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point. The area under the curve (AUC) was 0.670.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289316&req=5

Fig1: Receiver operating characteristic (ROC) curve analysis of preoperative CA19-9 for prediction of five-year survival of patients with pancreatic carcinoma An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point. The area under the curve (AUC) was 0.670.
Mentions: The median preoperative serum CA19-9 level of the 147 patients was 122 U/mL. An ROC curve demonstrated that a preoperative serum CA19-9 level of 40 U/mL was the optimal cutoff point for five-year survival, with a sensitivity of 66.7% and a specificity of 73.6%. The area under the curve (AUC) was 0.670 (FigureĀ 1).Table 1

Bottom Line: Of 147 patients, 18 survived for more than five years after surgery without disease recurrence.A univariate analyses demonstrated that: two or fewer lymph node metastases (P=0.014), a preoperative serum carbohydrate antigen 19-9 (CA19-9) level of 40 U/mL or less (P=0.0018), an absence of intrapancreatic nerve invasion (P=0.028), and undergoing an R0 resection (P=0.011) were significantly associated with five-year survival.We conclude that number of lymph node metastases being two or less, a preoperative serum CA19-9 level of 40 U/mL or less, and undergoing an R0 resection may be independent predictive factors to identify actual five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. kenjiro@med.osaka-cu.ac.jp.

ABSTRACT

Background: Clinical factors determining short-term survival after pancreatectomy have been well studied, but factors predicting long-term survival with curative resection are poorly understood in pancreatic carcinoma. Our objective was to identify clinical and pathological features of five-year disease-free survivors after surgical resection of pancreatic adenocarcinoma.

Methods: The clinical and pathological data from 147 patients who underwent a potentially curative resection for pancreatic adenocarcinoma at our institution between 1988 and 2012 were retrospectively analyzed.

Results: Of 147 patients, 18 survived for more than five years after surgery without disease recurrence. A univariate analyses demonstrated that: two or fewer lymph node metastases (P=0.014), a preoperative serum carbohydrate antigen 19-9 (CA19-9) level of 40 U/mL or less (P=0.0018), an absence of intrapancreatic nerve invasion (P=0.028), and undergoing an R0 resection (P=0.011) were significantly associated with five-year survival. A logistic regression model identified the following independent cancer-related predictors of five-year survivors: having two or fewer lymph node metastases (odds ratio (OR): 6.02; 95% confidence interval (CI): 1.08 to 112.98; P=0.0385), a preoperative serum CA19-9 level of 40 U/mL or less (OR: 5.02; 95% CI: 1.68 to 16.48; P=0.0036), and undergoing an R0 resection (OR: 3.63; 95% CI: 1.12 to 14.28; P=0.0316).

Conclusions: We conclude that number of lymph node metastases being two or less, a preoperative serum CA19-9 level of 40 U/mL or less, and undergoing an R0 resection may be independent predictive factors to identify actual five-year survivors after pancreatectomy for pancreatic adenocarcinoma.

Show MeSH
Related in: MedlinePlus