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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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A combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less. The subgroup of preoperative serum CA19-9 ≤ 40 U/mL and R0 resection, together with number of lymph node metastases ≤2, is associated with a probability of five-year survival of 42.1%. MST, median survival time.
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Fig2: A combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less. The subgroup of preoperative serum CA19-9 ≤ 40 U/mL and R0 resection, together with number of lymph node metastases ≤2, is associated with a probability of five-year survival of 42.1%. MST, median survival time.

Mentions: On the basis of the multivariate analysis results, a combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less was performed. When each of the three predictors was counted as one point and the points were calculated for all 147 cases, a good stratified survival curve was obtained, showing the longer survival in the higher points: median survival times of three, two, one, and zero points were 39.0, 17.0, 8.2, and 8.6 months, respectively (P <0.0001) (Figure 2).Figure 2


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)

A combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less. The subgroup of preoperative serum CA19-9 ≤ 40 U/mL and R0 resection, together with number of lymph node metastases ≤2, is associated with a probability of five-year survival of 42.1%. MST, median survival time.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: A combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less. The subgroup of preoperative serum CA19-9 ≤ 40 U/mL and R0 resection, together with number of lymph node metastases ≤2, is associated with a probability of five-year survival of 42.1%. MST, median survival time.
Mentions: On the basis of the multivariate analysis results, a combined analysis of the preoperative serum CA19-9 level, R0 resection, and number of lymph node metastases being two or less was performed. When each of the three predictors was counted as one point and the points were calculated for all 147 cases, a good stratified survival curve was obtained, showing the longer survival in the higher points: median survival times of three, two, one, and zero points were 39.0, 17.0, 8.2, and 8.6 months, respectively (P <0.0001) (Figure 2).Figure 2

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