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A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?

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Title: A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?
Authors: Nakamura, Toru Browse this author →KAKEN DB
Asano, Toshimichi Browse this author
Okamura, Keisuke Browse this author →KAKEN DB
Tsuchikawa, Takahiro Browse this author →KAKEN DB
Murakami, Soichi Browse this author →KAKEN DB
Kurashima, Yo Browse this author →KAKEN DB
Ebihara, Yuma Browse this author →KAKEN DB
Noji, Takehiro Browse this author →KAKEN DB
Nakanishi, Yoshitsugu Browse this author →KAKEN DB
Tanaka, Kimitaka Browse this author
Shichinohe, Toshiaki Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Resectable pancreatic cancer
Preoperative prognostic scoring
Upfront surgery
Issue Date: May-2019
Publisher: Springer
Journal Title: Journal of gastrointestinal surgery
Volume: 23
Issue: 5
Start Page: 990
End Page: 996
Publisher DOI: 10.1007/s11605-018-3972-x
PMID: 30242645
Abstract: 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.
Rights: The final publication is available at Springer via http://dx.doi.org/10.1007/s11605-018-3972-x
Type: article (author version)
URI: http://hdl.handle.net/2115/77807
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 中村 透

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