Recurrence pattern and its risk factors in patients with resected pancreatic ductal adenocarcinoma – A retrospective analysis of 272 patients

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pancreatology Pub Date : 2024-09-01 DOI:10.1016/j.pan.2024.07.017

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Abstract

Background

The aim of this study was to investigate the patterns of recurrence and their associated risk factors in patients who underwent resection for pancreatic carcinoma.

Methods

This retrospective study included 272 patients, who underwent Ro/R1-resection of PDAC from 2005 to 2020 at the University Hospital Erlangen. Risk factors for different recurrence patterns and the prognostic value of recurrence pattern on the overall survival after recurrence were evaluated.

Results

61 % of the patients experienced recurrence, mostly within the first 12 postoperative months (62 %) and in the form of metastases (87 %). The median overall survival from recurrence was 9.2 months. The preoperative absence of diabetes and the presence of lymph node metastasis were independent risk factors for recurrence and a preoperative CA19-9 exceeding 97 U/ml for early recurrence. Additionally, lymph node metastases were associated with a higher risk of metastatic recurrence. Early recurrence, but not the site of recurrence, was identified as an independent prognostic factor for worse overall survival from recurrence.

Conclusion

The occurrence of recurrence and especially of early and metastatic recurrence are associated with a worse overall survival. Patients lacking preoperative diabetes, having high preoperative CA19-9 values and lymph node metastases are particularly at risk for (early) recurrence.

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切除胰腺导管腺癌患者的复发模式及其风险因素--对272名患者的回顾性分析。

背景：本研究旨在调查胰腺癌切除术患者的复发模式及其相关风险因素：本研究旨在调查接受胰腺癌切除术的患者的复发模式及其相关风险因素：这项回顾性研究纳入了2005年至2020年期间在埃尔兰根大学医院接受Ro/R1-切除术的272名PDAC患者。研究评估了不同复发模式的风险因素以及复发模式对复发后总生存期的预后价值：结果：61%的患者经历过复发，大部分是在术后最初的12个月内复发（62%），复发形式为转移（87%）。复发后总生存期的中位数为 9.2 个月。术前无糖尿病和存在淋巴结转移是复发的独立危险因素，术前CA19-9超过97 U/ml是早期复发的独立危险因素。此外，淋巴结转移与较高的转移性复发风险相关。早期复发，而非复发部位，被认为是导致复发后总生存率降低的独立预后因素：结论：复发，尤其是早期复发和转移性复发与较差的总生存率有关。术前无糖尿病、术前CA19-9值高和淋巴结转移的患者尤其面临（早期）复发的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.