Factors predicting survival in patients with locally advanced pancreatic cancer undergoing pancreatectomy with arterial resection

被引：15

作者：

Napoli, Niccolo ^{[5
]}

Kauffmann, Emanuele ^{[5
]}

Cacace, Concetta ^{[5
]}

Menonna, Francesca ^{[5
]}

Caramella, Davide ^{[1
]}

Cappelli, Carla ^{[1
]}

Campani, Daniela ^{[2
]}

Cacciato Insilla, Andrea ^{[2
]}

Vasile, Enrico ^{[3
]}

Vivaldi, Caterina ^{[3
]}

Fornaro, Lorenzo ^{[3
]}

Amorese, Gabriella ^{[4
]}

Vistoli, Fabio ^{[5
]}

Boggi, Ugo ^{[5
]}

机构：

[1] Univ Pisa, Azienda Osped Univ Pisana, Div Radiol, Pisa, Italy

[2] Univ Pisa, Azienda Osped Univ Pisana, Div Pathol, Pisa, Italy

[3] Univ Pisa, Azienda Osped Univ Pisana, Div Oncol, Pisa, Italy

[4] Univ Pisa, Azienda Osped Univ Pisana, Div Anesthesia & Intens Care, Pisa, Italy

[5] Univ Pisa, Azienda Osped Univ Pisana, Div Gen & Transplant Surg, Pisa, Italy

来源：

UPDATES IN SURGERY | 2021年 / 73卷 / 01期

关键词：

Locally advanced pancreatic cancer; Pancreatic cancer; Pancreatectomy; Arterial resection; Vascular resection; Prognostic score; INTERNATIONAL STUDY-GROUP; TO-LYMPHOCYTE RATIO; CLINICAL-USEFULNESS; R1; RESECTION; SURGERY; CA125; COMPLICATIONS; CHEMOTHERAPY; METAANALYSIS; METASTASIS;

D O I：

10.1007/s13304-020-00883-7

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Pancreatectomy with arterial resection is a treatment option in selected patients with locally advanced pancreatic cancer. This study aimed to identify factors predicting cancer-specific survival in this patient population. A single-Institution prospective database was used. Pre-operative prognostic factors were identified and used to develop a prognostic score. Matching with pathologic parameters was used for internal validation. In a patient population with a median Ca 19.9 level of 19.8 U/mL(IQR: 7.1-77), cancer-specific survival was predicted by: metabolic deterioration of diabetes (OR = 0.22,p = 0.0012), platelet count (OR = 1.00;p = 0.0013), serum level of Ca 15.3 (OR = 1.01,p = 0.0018) and Ca 125 (OR = 1.02,p = 0.00000137), neutrophils-to-lymphocytes ratio (OR = 1.16;p = 0.00015), lymphocytes-to-monocytes ratio (OR = 0.88;p = 0.00233), platelets-to-lymphocytes ratio (OR = 0.99;p = 0.00118), and FOLFIRINOX neoadjuvant chemotherapy (OR = 0.57;p = 0.00144). A prognostic score was developed and three risk groups were identified. Harrell's C-Index was 0.74. Median cancer-specific survival was 16.0 months (IQR: 12.3-28.2) for the high-risk group, 24.7 months (IQR: 17.6-33.4) for the intermediate-risk group, and 39.0 months (IQR: 22.7-NA) for the low-risk group (p = 0.0003). Matching the three risk groups against pathology parameters, N2 rate was 61.9, 42.1, and 23.8% (p = 0.04), median value of lymph-node ratio was 0.07 (IQR: 0.05-0.14), 0.04 (IQR:0.02-0.07), and 0.03 (IQR: 0.01-0.04) (p = 0.008), and mean value of logarithm odds of positive nodes was - 1.07 +/- 0.5, - 1.3 +/- 0.4, and - 1.4 +/- 0.4 (p = 0.03), in the high-risk, intermediate-risk, and low-risk groups, respectively. An online calculator is available at. The prognostic factors identified in this study predict cancer-specific survival in patients with locally advanced pancreatic cancer and low Ca 19.9 levels undergoing pancreatectomy with arterial resection.

引用

页码：233 / 249

页数：17

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