Preoperative predictors for early recurrence of resectable pancreatic cancer

The first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation m...

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Bibliographic Details
Published in:	World journal of surgical oncology Vol. 15; no. 1; p. 16
Main Authors:	Nishio, Kohei, Kimura, Kenjiro, Amano, Ryosuke, Yamazoe, Sadaaki, Ohrira, Go, Nakata, Bunzo, Hirakawa, Kosei, Ohira, Masaichi
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 10-01-2017 BioMed Central
Subjects:	Adenocarcinoma - blood Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Analysis Antigens Antigens, Neoplasm - blood Biomarkers, Tumor - blood Body mass index CA-19-9 Antigen - blood Cancer therapies Care and treatment Chemotherapy Clinical trials Committees Consent Ethics Female Follow-Up Studies Funding Humans Lymphatic system Male Metastasis Middle Aged Neoplasm Grading Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - diagnosis Neoplasm Staging Pancreatectomy Pancreatic cancer Pancreatic Neoplasms - blood Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Preoperative Care Prognosis Recurrence (Disease) Researchers Risk factors Statistical analysis Studies Surgery Survival Rate Preoperative predictors Histological grade Resectable pancreatic cancer CA19-9 Tumor diameter
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Summary:	The first-line treatment for resectable pancreatic cancer (RPC) is surgical resection. However, our patients have often experienced early recurrence after curative resection for RPC, with desperately poor prognosis. Some reports indicated that minimally distant metastasis not detected at operation might cause early recurrence. The present study aimed to identify preoperative clinicopathological features of early recurrence after curative resection of RPC. Ninety RPC patients who underwent curative resection between 2000 and 2014 at our institution were retrospectively analyzed. Of the 90 patients, 32 had recurrence within 1 year. Univariate analysis demonstrated that preoperative serum carbohydrate antigen (CA19-9) ≥529 U/mL (P = 0.0011), preoperative serum s-pancreas-1 antigen (SPan-1) ≥37 U/mL (P = 0.0038), and histological grades G2-G4 (P = 0.0158) were significantly associated with recurrence within 1 year after curative resection. Multivariate analysis demonstrated that preoperative serum CA19-9 ≥ 529 U/mL (P = 0.0477) and histological grade G2-G4 (P = 0.0129) were independent predictors of recurrence within 1 year. Recurrent cases within 1 year postoperatively had significantly more distant metastasis than cases with no recurrence within 1 year (P < 0.001). Preoperative serum CA19-9 ≥ 529 U/mL and histological grades G2-G4 were independent predictive factors for recurrence within 1 year after pancreatectomy for RPC. Furthermore, recurrent cases within 1 year had more frequent distant metastasis than cases with no recurrence within 1 year. These results suggest that RPC patients with preoperative serum CA19-9 ≥ 529 U/mL should receive preoperative therapy rather than surgery.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1477-7819 1477-7819
DOI:	10.1186/s12957-016-1078-z