胰腺腺癌切除术后结构性监测的临床影响:一项回顾性队列研究的结果。

IF 2 4区 医学 Q3 ONCOLOGY Oncology Research and Treatment Pub Date : 2023-01-01 Epub Date: 2022-12-16 DOI:10.1159/000528722
Danmei Zhang, Stephan Kruger, Karoline Schirle, Volker Heinemann, Klara Dorman, Christoph Benedikt Westphalen, Lena Weiss, Leonie Gebauer, Michael Günther, Steffen Ormanns, Jens Werner, Michael von Bergwelt-Baildon, Stefan Boeck, Michael Haas
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引用次数: 0

摘要

导言:迄今为止,手术仍是治疗胰腺癌的唯一可能治愈方法。为了分析有组织的术后随访计划对临床的影响,我们对慕尼黑大学治疗的一组胰腺癌切除患者进行了回顾性分析:从现有的两个研究队列中筛选出2002年至2017年期间在本中心接受切除术并进行定期随访的胰腺癌患者。复发诊断按时间(预定随访内或预定随访外)和检测方式(影像学、CA 19-9升高或临床恶化)分类,并与无病生存率和总生存率(OS)相关:本次分析共纳入125例切除胰腺腺癌患者。整个组群的中位生存期为 21.1 个月。在这125名患者中,103名(82.4%)患者有复发记录。与计划外随访时发现的复发(17 例,16.5%)相比,在计划内随访时发现的肿瘤复发(86 例,83.5%)显著提高了患者的生存期(中位 25.5 个月 vs. 20.2 个月,p = 0.019)。与通过临床恶化发现复发的患者(4人,占3.9%)相比,通过影像学或实验室异常发现复发的患者(99人,占96.0%)的中位生存期更长(24.8个月对15.1个月,P = 0.007):讨论:胰腺导管腺癌切除术后的结构性随访可能会对患者的预后产生影响。需要进行前瞻性试验来评估术后随访计划的临床影响。
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Clinical Impact of Structured Post-Operative Surveillance in Resected Pancreatic Adenocarcinoma: Results from a Retrospective Cohort Study.

Introduction: To this date, surgery remains the only potentially curative approach in the treatment of pancreatic cancer. To analyse the clinical impact of a structured post-operative follow-up programme, we retrospectively analysed a cohort of resected pancreatic adenocarcinoma patients treated at LMU Munich.

Methods: Pancreatic adenocarcinoma patients who underwent resection and presented for regular follow-up visits at our centre between 2002 and 2017 were identified from two existing study cohorts. Diagnosis of recurrences was categorised by timing (within or outside a scheduled follow-up visit) and detection modality (imaging, CA 19-9 increase, or clinical deterioration) and correlated with disease-free survival and overall survival (OS).

Results: One hundred and twenty-five patients with resected pancreatic adenocarcinoma were included in this analysis. Median OS in the whole cohort was 21.1 months. Of these 125 patients, 103 (82.4%) patients had a documented relapse. Tumour recurrences detected within a scheduled follow-up visit (n = 86, 83.5%) compared to recurrences becoming apparent at an unplanned visit (n = 17, 16.5%) were associated with a significantly improved OS (median 25.5 vs. 20.2 months, p = 0.019). Compared to patients with recurrence detected by clinical deterioration (n = 4, 3.9%), patients with recurrences detected by imaging or laboratory abnormalities (n = 99, 96.0%) had a longer median OS (24.8 vs. 15.1 months, p = 0.007).

Discussion: A structured follow-up after pancreatic ductal adenocarcinoma resection may have an impact on patient outcome. Prospective trials are needed to evaluate the clinical impact of post-operative follow-up programmes.

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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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