دورية أكاديمية
أعرض في EDS

Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study.

التفاصيل البيبلوغرافية
العنوان: Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study.
المؤلفون: Seelen LWF; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Floortje van Oosten A; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands.; Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA., Brada LJH; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Groot VP; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Daamen LA; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Walma MS; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., van der Lek BF; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Liem MSL; Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands., Patijn GA; Department of Surgery, Isala Clinics, Zwolle, The Netherlands., Stommel MWJ; Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands., van Dam RM; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Koerkamp BG; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Busch OR; Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., de Hingh IHJT; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., van Eijck CHJ; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Besselink MG; Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Burkhart RA; Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA., Borel Rinkes IHM; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Wolfgang CL; Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA., Molenaar IQ; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., He J; Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA., van Santvoort HC; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands.
المصدر: Annals of surgery [Ann Surg] 2023 Jul 01; Vol. 278 (1), pp. 118-126. Date of Electronic Publication: 2022 Aug 11.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Pancreatic Neoplasms*/drug therapy , Pancreatic Neoplasms*/surgery, Humans ; Induction Chemotherapy ; Neoadjuvant Therapy ; Pancreas/pathology ; Combined Modality Therapy ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
مستخلص: Objective: To establish an evidence-based cutoff and predictors for early recurrence in patients with resected locally advanced pancreatic cancer (LAPC).
Background: It is unclear how many and which patients develop early recurrence after LAPC resection. Surgery in these patients is probably of little benefit.
Methods: We analyzed all consecutive patients undergoing resection of LAPC after induction chemotherapy who were included in prospective databases in The Netherlands (2015-2019) and the Johns Hopkins Hospital (2016-2018). The optimal definition for "early recurrence" was determined by the post-recurrence survival (PRS). Patients were compared for overall survival (OS). Predictors for early recurrence were evaluated using logistic regression analysis.
Results: Overall, 168 patients were included. After a median follow-up of 28 months, recurrence was observed in 118 patients (70.2%). The optimal cutoff for recurrence-free survival to differentiate between early (n=52) and late recurrence (n=66) was 6 months ( P <0.001). OS was 8.4 months [95% confidence interval (CI): 7.3-9.6] in the early recurrence group (n=52) versus 31.1 months (95% CI: 25.7-36.4) in the late/no recurrence group (n=116) ( P <0.001). A preoperative predictor for early recurrence was postinduction therapy carbohydrate antigen (CA) 19-9≥100 U/mL [odds ratio (OR)=4.15, 95% CI: 1.75-9.84, P =0.001]. Postoperative predictors were poor tumor differentiation (OR=4.67, 95% CI: 1.83-11.90, P =0.001) and no adjuvant chemotherapy (OR=6.04, 95% CI: 2.43-16.55, P <0.001).
Conclusions: Early recurrence was observed in one third of patients after LAPC resection and was associated with poor survival. Patients with post-induction therapy CA 19-9 ≥100 U/mL, poor tumor differentiation and no adjuvant therapy were especially at risk. This information is valuable for patient counseling before and after resection of LAPC.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20220811 Date Completed: 20230612 Latest Revision: 20230923
رمز التحديث: 20230923
DOI: 10.1097/SLA.0000000000005666
PMID: 35950757
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1140
DOI:10.1097/SLA.0000000000005666