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

Nakamura, Toru; Asano, Toshimichi; Okamura, Keisuke; Tsuchikawa, Takahiro; Murakami, Soichi; Kurashima, Yo; Ebihara, Yuma; Noji, Takehiro; Nakanishi, Yoshitsugu; Tanaka, Kimitaka; Shichinohe, Toshiaki; Hirano, Satoshi

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

Nakamura, Toru; Asano, Toshimichi; Okamura, Keisuke et al.

Journal of gastrointestinal surgery, 2019, 23(5), 990-996

Permalink : https://hdl.handle.net/2115/77807

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/77807
タイトル	A Preoperative Prognostic Scoring System to Predict Prognosis for Resectable Pancreatic Cancer : Who Will Benefit from Upfront Surgery?
著者	Nakamura, Toru ; Asano, Toshimichi ; Okamura, Keisuke ; Tsuchikawa, Takahiro ; Murakami, Soichi ; Kurashima, Yo ; Ebihara, Yuma ; Noji, Takehiro ; Nakanishi, Yoshitsugu ; Tanaka, Kimitaka ; Shichinohe, Toshiaki ; Hirano, Satoshi
e-Rad_Researcher 70645796 著者名 Nakamura, Toru
著者名 Asano, Toshimichi
e-Rad_Researcher 90724401 著者名 Okamura, Keisuke
e-Rad_Researcher 50507572 著者名 Tsuchikawa, Takahiro
e-Rad_Researcher 80706573 著者名 Murakami, Soichi
e-Rad_Researcher 40374350 著者名 Kurashima, Yo
e-Rad_Researcher 50632981 著者名 Ebihara, Yuma
e-Rad_Researcher 10739296 著者名 Noji, Takehiro
e-Rad_Researcher 40447058 著者名 Nakanishi, Yoshitsugu
著者名 Tanaka, Kimitaka
e-Rad_Researcher 70374353 著者名 Shichinohe, Toshiaki
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
言語	英語
キーワード	Resectable pancreatic cancer
	Preoperative prognostic scoring
	Upfront surgery
発行日	2019-05
出版者	Springer
収録物名	Journal of gastrointestinal surgery
巻(号)	23(5)
ページ	990-996
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	The final publication is available at Springer via http://dx.doi.org/10.1007/s11605-018-3972-x
PISSN	1091-255X
関連情報	PMID 30242645
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s11605-018-3972-x