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Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma

BACKGROUND: Recurrence after resection is the main factor for poor survival. The relationship between clinicopathological factors and recurrence after curative distal pancreatectomy for PDAC has rarely been reported separately. METHODS: Patients with PDAC after left‑sided pancreatectomy between May...

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Autores principales: Xia, Tao, Xu, Peng, Mou, Yiping, Zhang, Xizhou, Song, Shihao, Zhou, Yucheng, Lu, Chao, Zhu, Qicong, Xu, Yunyun, Jin, Weiwei, Wang, Yuanyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286495/
https://www.ncbi.nlm.nih.gov/pubmed/37349737
http://dx.doi.org/10.1186/s12957-023-03080-z
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author Xia, Tao
Xu, Peng
Mou, Yiping
Zhang, Xizhou
Song, Shihao
Zhou, Yucheng
Lu, Chao
Zhu, Qicong
Xu, Yunyun
Jin, Weiwei
Wang, Yuanyu
author_facet Xia, Tao
Xu, Peng
Mou, Yiping
Zhang, Xizhou
Song, Shihao
Zhou, Yucheng
Lu, Chao
Zhu, Qicong
Xu, Yunyun
Jin, Weiwei
Wang, Yuanyu
author_sort Xia, Tao
collection PubMed
description BACKGROUND: Recurrence after resection is the main factor for poor survival. The relationship between clinicopathological factors and recurrence after curative distal pancreatectomy for PDAC has rarely been reported separately. METHODS: Patients with PDAC after left‑sided pancreatectomy between May 2015 and August 2021 were retrospectively identified. RESULTS: One hundred forty-one patients were included. Recurrence was observed in 97 patients (68.8%), while 44 (31.2%) patients had no recurrence. The median RFS was 8.8 months. The median OS was 24.9 months. Local recurrence was the predominant first detected recurrence site (n = 36, 37.1%), closely followed by liver recurrence (n = 35, 36.1%). Multiple recurrences occurred in 16 (16.5%) patients, peritoneal recurrence in 6 (6.2%) patients, and lung recurrence in 4 (4.1%) patients. High CA19-9 value after surgery, poor differentiation grade, and positive lymph nodes were found to be independently associated with recurrence. The patients receiving adjuvant chemotherapy had a decreased likelihood of recurrence. In the high CA19-9 value cohort, the median PFS and OS of the patients with or without chemotherapy were 8.0 VS. 5.7 months and 15.6 VS. 13.8 months, respectively. In the normal CA19-9 value cohort, there was no significant difference in PFS with or without chemotherapy (11.7 VS. 10.0 months, P = 0.147). However, OS was significantly longer in the patients with chemotherapy (26.4 VS. 13.8 months, P = 0.019). CONCLUSIONS: Tumor biologic characteristics, such as T stage, tumor differentiation and positive lymph nodes, affecting CA19-9 value after surgery are associated with patterns and timing of recurrence. Adjuvant chemotherapy significantly reduced recurrence and improved survival. Chemotherapy is strongly recommended in patients with high CA199 after surgery.
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spelling pubmed-102864952023-06-23 Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma Xia, Tao Xu, Peng Mou, Yiping Zhang, Xizhou Song, Shihao Zhou, Yucheng Lu, Chao Zhu, Qicong Xu, Yunyun Jin, Weiwei Wang, Yuanyu World J Surg Oncol Research BACKGROUND: Recurrence after resection is the main factor for poor survival. The relationship between clinicopathological factors and recurrence after curative distal pancreatectomy for PDAC has rarely been reported separately. METHODS: Patients with PDAC after left‑sided pancreatectomy between May 2015 and August 2021 were retrospectively identified. RESULTS: One hundred forty-one patients were included. Recurrence was observed in 97 patients (68.8%), while 44 (31.2%) patients had no recurrence. The median RFS was 8.8 months. The median OS was 24.9 months. Local recurrence was the predominant first detected recurrence site (n = 36, 37.1%), closely followed by liver recurrence (n = 35, 36.1%). Multiple recurrences occurred in 16 (16.5%) patients, peritoneal recurrence in 6 (6.2%) patients, and lung recurrence in 4 (4.1%) patients. High CA19-9 value after surgery, poor differentiation grade, and positive lymph nodes were found to be independently associated with recurrence. The patients receiving adjuvant chemotherapy had a decreased likelihood of recurrence. In the high CA19-9 value cohort, the median PFS and OS of the patients with or without chemotherapy were 8.0 VS. 5.7 months and 15.6 VS. 13.8 months, respectively. In the normal CA19-9 value cohort, there was no significant difference in PFS with or without chemotherapy (11.7 VS. 10.0 months, P = 0.147). However, OS was significantly longer in the patients with chemotherapy (26.4 VS. 13.8 months, P = 0.019). CONCLUSIONS: Tumor biologic characteristics, such as T stage, tumor differentiation and positive lymph nodes, affecting CA19-9 value after surgery are associated with patterns and timing of recurrence. Adjuvant chemotherapy significantly reduced recurrence and improved survival. Chemotherapy is strongly recommended in patients with high CA199 after surgery. BioMed Central 2023-06-22 /pmc/articles/PMC10286495/ /pubmed/37349737 http://dx.doi.org/10.1186/s12957-023-03080-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Xia, Tao
Xu, Peng
Mou, Yiping
Zhang, Xizhou
Song, Shihao
Zhou, Yucheng
Lu, Chao
Zhu, Qicong
Xu, Yunyun
Jin, Weiwei
Wang, Yuanyu
Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title_full Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title_fullStr Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title_full_unstemmed Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title_short Factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
title_sort factors predicting recurrence after left‑sided pancreatectomy for pancreatic ductal adenocarcinoma
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286495/
https://www.ncbi.nlm.nih.gov/pubmed/37349737
http://dx.doi.org/10.1186/s12957-023-03080-z
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