論文

国際誌
2022年2月

Development of a Biomarker-Based Scoring System Predicting Early Recurrence of Resectable Pancreatic Duct Adenocarcinoma.

Annals of surgical oncology
  • Keinosuke Ishido
  • ,
  • Norihisa Kimura
  • ,
  • Taiichi Wakiya
  • ,
  • Hayato Nagase
  • ,
  • Yutaro Hara
  • ,
  • Taishu Kanda
  • ,
  • Hiroaki Fujita
  • ,
  • Kenichi Hakamada

29
2
開始ページ
1281
終了ページ
1293
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1245/s10434-021-10866-6

BACKGROUND: Resectable pancreatic ductal adenocarcinoma (R-PDAC) often recurs early after radical resection, which is associated with poor prognosis. Predicting early recurrence preoperatively is useful for determining the optimal treatment. PATIENTS AND METHODS: One hundred and seventy-eight patients diagnosed with R-PDAC on computed tomography (CT) imaging and undergoing radical resection at Hirosaki University Hospital from 2005 to 2019 were retrospectively analyzed. Patients with recurrence within 6 months after resection formed the early recurrence (ER) group, while other patients constituted the non-early recurrence (non-ER) group. Early recurrence prediction score (ERP score) was developed using preoperative parameters. RESULTS: ER was observed in 45 patients (25.3%). The ER group had significantly higher preoperative CA19-9 (p = 0.03), serum SPan-1 (p = 0.006), and CT tumor diameter (p = 0.01) compared with the non-ER group. The receiver operating characteristic (ROC) curve analysis identified cutoff values for CA19-9 (133 U/mL), SPan-1 (78.2 U/mL), and preoperative tumor diameter (23 mm). When the parameter exceeded the cutoff level, 1 point was given, and the total score of the three factors was defined as the ERP score. The group with an ERP score of 3 had postoperative recurrence-free survival (RFS) of 5.5 months (95% CI 3.02-7.98). Multivariate analysis for ER-related perioperative and surgical factors identified ERP score of 3 [odds ratio (OR) 4.63 (95% CI 1.82-11.78), p = 0.0013] and R1 resection [OR 3.20 (95% CI 1.01-10.17), p = 0.049] as independent predictors of ER. CONCLUSIONS: For R-PDAC, ER could be predicted by the scoring system using preoperative serum CA19-9 and SPan-1 levels and CT tumor diameter, which may have great significance in identifying patients with poor prognoses and avoiding unnecessary surgery.

リンク情報
DOI
https://doi.org/10.1245/s10434-021-10866-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34608555
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8724152
ID情報
  • DOI : 10.1245/s10434-021-10866-6
  • PubMed ID : 34608555
  • PubMed Central 記事ID : PMC8724152

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