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Impact of adjuvant therapy in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: an international multicenter cohort study.

التفاصيل البيبلوغرافية
العنوان: Impact of adjuvant therapy in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: an international multicenter cohort study.
المؤلفون: Choi M; Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea., Wang SE; Department of Surgery, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan., Park JS; Department of Surgery, Gangnam Severance Hospital., Kim HS; Department of Surgery, Gangnam Severance Hospital., Choi SH; Department of Surgery, CHA Bundang Medical Center, CHA University, Seongam-si, Korea., Lee JH; Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea., Chong JU; Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea., Nagakawa Y; Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan., Wada K; Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan., Nakamura Y; Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan., Sunagawa H; Department of Gastrointestinal Surgery, Nakagami Hospital, Okinawa, Japan., Dasari BV; Department of HPB and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, UK., Peng CM; Department of General Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan., Seng LL; Hepatopancreatobiliary Unit, Department of General Surgery, Changi General Hospital, Singapore., Wolters H; Department of Visceral and General Surgery, St. Josefs-Hospital, Dortmund, Germany., Gurbadam U; Department of Surgery, National Cancer Center Hospital, Ulan Bator, Mongolia., Park BU; Department of Pathology, The University of California, San Francisco, CA., Winslow E; Department of Pathology, The University of California, San Francisco, CA.; MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA., Fishbein T; MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA., Hawksworth J; MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA., Radkani P; MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA., Kang CM; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
المصدر: International journal of surgery (London, England) [Int J Surg] 2023 Oct 01; Vol. 109 (10), pp. 2906-2913. Date of Electronic Publication: 2023 Oct 01.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
Original Publication: London : Surgical Associates Ltd., c2004-
مواضيع طبية MeSH: Pancreatic Intraductal Neoplasms*/surgery , Adenocarcinoma, Mucinous*/surgery , Pancreatic Neoplasms*/surgery , Carcinoma, Pancreatic Ductal*/surgery, Humans ; Retrospective Studies ; Neoplasm Invasiveness/pathology ; Pancreatic Neoplasms
مستخلص: Background: Adjuvant therapy prolongs survival in patients with pancreatic ductal adenocarcinoma. However, no clear guidelines are available regarding the oncologic effects of adjuvant therapy (AT) in resected invasive intraductal papillary mucinous neoplasms (IPMN). The aim was to investigate the potential role of AT in patients with resected invasive IPMN.
Materials and Methods: From 2001 to 2020, 332 patients with invasive pancreatic IPMN were retrospectively reviewed in 15 centres in eight countries. Propensity score-matched and stage-matched survival analyses were conducted.
Results: A total of 289 patients were enroled in the study after exclusion (neoadjuvant therapy, unresectable disease, uncertain AT status, and stage IV). A total of 170 patients were enroled in a 1:1 propensity score-matched analysis according to the covariates. In the overall cohort, disease-free survival was significantly better in the surgery alone group than in the AT group ( P =0.003), but overall survival (OS) was not ( P =0.579). There were no significant differences in OS in the stage-matched analysis between the surgery alone and AT groups (stage I, P =0.402; stage II, P =0.179). AT did not show a survival benefit in the subgroup analysis according to nodal metastasis (N0, P =0.481; N+, P =0.705). In multivariate analysis, node metastasis (hazard ratio, 4.083; 95% CI, 2.408-6.772, P <0.001), and cancer antigen 19-9 greater than or equal to 100 (hazard ratio, 2.058; 95% CI, 1.247-3.395, P =0.005) were identified as adverse prognostic factors in resected invasive IPMN.
Conclusion: The current AT strategy may not be recommended to be performed with resected invasive IPMN in stage I and II groups, unlike pancreatic ductal adenocarcinoma. Further investigations of the potential role of AT in invasive IPMN are recommended.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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تواريخ الأحداث: Date Created: 20230610 Date Completed: 20231023 Latest Revision: 20231213
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10583921
DOI: 10.1097/JS9.0000000000000537
PMID: 37300881
قاعدة البيانات: MEDLINE
الوصف
تدمد:1743-9159
DOI:10.1097/JS9.0000000000000537