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Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma

Background. Survival after surgery for pancreatic ductal adenocarcinoma (PDAC) remains poor, due to early recurrence (ER) of the disease. A global definition of ER is lacking and different cut-off values (6, 8, and 12 months) have been adopted. The aims of this study were to define the optimal cut-o...

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Autores principales: Nappo, Gennaro, Donisi, Greta, Capretti, Giovanni, Ridolfi, Cristina, Pagnanelli, Michele, Nebbia, Martina, Bozzarelli, Silvia, Petitti, Tommasangelo, Gavazzi, Francesca, Zerbi, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137113/
https://www.ncbi.nlm.nih.gov/pubmed/37185395
http://dx.doi.org/10.3390/curroncol30040282
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author Nappo, Gennaro
Donisi, Greta
Capretti, Giovanni
Ridolfi, Cristina
Pagnanelli, Michele
Nebbia, Martina
Bozzarelli, Silvia
Petitti, Tommasangelo
Gavazzi, Francesca
Zerbi, Alessandro
author_facet Nappo, Gennaro
Donisi, Greta
Capretti, Giovanni
Ridolfi, Cristina
Pagnanelli, Michele
Nebbia, Martina
Bozzarelli, Silvia
Petitti, Tommasangelo
Gavazzi, Francesca
Zerbi, Alessandro
author_sort Nappo, Gennaro
collection PubMed
description Background. Survival after surgery for pancreatic ductal adenocarcinoma (PDAC) remains poor, due to early recurrence (ER) of the disease. A global definition of ER is lacking and different cut-off values (6, 8, and 12 months) have been adopted. The aims of this study were to define the optimal cut-off for the definition of ER and predictive factors for ER. Methods. Recurrence was recorded for all consecutive patients undergoing upfront surgery for PDAC at our institute between 2010 and 2017. Receiver operating characteristic (ROC) curves were utilized, to estimate the optimal cut-off for the definition of ER as a predictive factor for poor post-progression survival (PPS). To identify predictive factors of ER, univariable and multivariable logistic regression models were used. Results. Three hundred and fifty one cases were retrospectively evaluated. The recurrence rate was 76.9%. ER rates were 29.0%, 37.6%, and 47.6%, when adopting 6, 8, and 12 months as cut-offs, respectively. A significant difference in median PPS was only shown between ER and late recurrence using 12 months as cut-off (p = 0.005). In the multivariate analysis, a pre-operative value of CA 19-9 > 70.5 UI/L (OR 3.10 (1.41–6.81); p = 0.005) and the omission of adjuvant treatment (OR 0.18 (0.08–0.41); p < 0.001) were significant predictive factors of ER. Conclusions. A twelve-months cut-off should be adopted for the definition of ER. Almost 50% of upfront-resected patients presented ER, and it significantly affected the prognosis. A high preoperative value of CA 19-9 and the omission of adjuvant treatment were the only predictive factors for ER.
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spelling pubmed-101371132023-04-28 Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma Nappo, Gennaro Donisi, Greta Capretti, Giovanni Ridolfi, Cristina Pagnanelli, Michele Nebbia, Martina Bozzarelli, Silvia Petitti, Tommasangelo Gavazzi, Francesca Zerbi, Alessandro Curr Oncol Article Background. Survival after surgery for pancreatic ductal adenocarcinoma (PDAC) remains poor, due to early recurrence (ER) of the disease. A global definition of ER is lacking and different cut-off values (6, 8, and 12 months) have been adopted. The aims of this study were to define the optimal cut-off for the definition of ER and predictive factors for ER. Methods. Recurrence was recorded for all consecutive patients undergoing upfront surgery for PDAC at our institute between 2010 and 2017. Receiver operating characteristic (ROC) curves were utilized, to estimate the optimal cut-off for the definition of ER as a predictive factor for poor post-progression survival (PPS). To identify predictive factors of ER, univariable and multivariable logistic regression models were used. Results. Three hundred and fifty one cases were retrospectively evaluated. The recurrence rate was 76.9%. ER rates were 29.0%, 37.6%, and 47.6%, when adopting 6, 8, and 12 months as cut-offs, respectively. A significant difference in median PPS was only shown between ER and late recurrence using 12 months as cut-off (p = 0.005). In the multivariate analysis, a pre-operative value of CA 19-9 > 70.5 UI/L (OR 3.10 (1.41–6.81); p = 0.005) and the omission of adjuvant treatment (OR 0.18 (0.08–0.41); p < 0.001) were significant predictive factors of ER. Conclusions. A twelve-months cut-off should be adopted for the definition of ER. Almost 50% of upfront-resected patients presented ER, and it significantly affected the prognosis. A high preoperative value of CA 19-9 and the omission of adjuvant treatment were the only predictive factors for ER. MDPI 2023-03-27 /pmc/articles/PMC10137113/ /pubmed/37185395 http://dx.doi.org/10.3390/curroncol30040282 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nappo, Gennaro
Donisi, Greta
Capretti, Giovanni
Ridolfi, Cristina
Pagnanelli, Michele
Nebbia, Martina
Bozzarelli, Silvia
Petitti, Tommasangelo
Gavazzi, Francesca
Zerbi, Alessandro
Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title_full Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title_fullStr Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title_full_unstemmed Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title_short Early Recurrence after Upfront Surgery for Pancreatic Ductal Adenocarcinoma
title_sort early recurrence after upfront surgery for pancreatic ductal adenocarcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137113/
https://www.ncbi.nlm.nih.gov/pubmed/37185395
http://dx.doi.org/10.3390/curroncol30040282
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