Impact of Tumor Size on the Outcomes of Patients with Resectable Distal Pancreatic Cancer: Lessons Learned from a Series of ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-08-17

AUTHORS

Genki Watanabe, Yuta Ushida, Atsushi Oba, Yoshihiro Ono, Takafumi Sato, Yosuke Inoue, Yu Takahashi, Akio Saiura, Hiromichi Ito

ABSTRACT

BackgroundNeoadjuvant therapy is used for borderline resectable pancreatic ductal adenocarcinoma (PDAC) with high risk of incomplete resection and early recurrence. Because distal PDAC is rare, the optimal criteria for neoadjuvant therapy specific for distal PDAC remain unclear. We hypothesized large distal PDAC would recur earlier than small distal PDAC.ObjectiveThe aim of this study was to identify the risk factors for failure of upfront resection for resectable distal PDAC.MethodsThe study cohort comprised 158 patients with resectable distal PDAC who underwent radical resection. The long-term outcomes were recurrence-free survival (RFS), disease-specific survival (DSS), and post-recurrence survival (PRS).ResultsR0 resection was achieved in 92% of patients, and median DSS for the entire cohort was 31 months. Among 103 patients who developed recurrence, 32 (31%) developed recurrence within 6 months. The median PRS and DSS for those with early recurrence was 6 and 10 months, respectively, compared with 11 and 30 months, respectively, for those with late recurrence (p = 0.017 and p < 0.001, respectively). Patients with tumors > 4 cm had higher rates of R1 resection (16%) and concomitant resection of another organ (19%) than those with smaller tumors (4% and 2%, p = 0.009 and p < 0.001, respectively). In multivariate analysis, tumor > 4 cm remained a significant predictor of early recurrence (p < 0.001, hazard ratio [HR] 6.51), shorter RFS (p = 0.018, HR 1.71), and shorter DSS (p = 0.002, HR 2.07).ConclusionTumor size > 4 cm is a reliable predictor of early recurrence after resection of distal PDAC, and neoadjuvant therapy may help select patients who can benefit from radical resection. More... »

PAGES

378-388

References to SciGraph publications

  • 2019-02-27. Left kidney mobilization technique during radical antegrade modular pancreatosplenectomy (RAMPS) in LANGENBECK'S ARCHIVES OF SURGERY
  • 2016-11-15. Role of Radical Antegrade Modular Pancreatosplenectomy (RAMPS) and Pancreatic Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 2003-12-01. Is extended resection for adenocarcinoma of the body or tail of the pancreas justified? in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2017-04-10. Asymptomatic Pancreatic Cancer: Does Incidental Detection Impact Long-Term Outcomes? in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2019-03-13. Neoadjuvant Chemotherapy with Gemcitabine Plus Nab-Paclitaxel for Borderline Resectable Pancreatic Cancer Potentially Improves Survival and Facilitates Surgery in ANNALS OF SURGICAL ONCOLOGY
  • 2018-09-18. Resectable Distal Pancreas Cancer: Time to Reconsider the Role of Upfront Surgery in ANNALS OF SURGICAL ONCOLOGY
  • 2015-07-08. Efficacy of Neoadjuvant Versus Adjuvant Therapy for Resectable Pancreatic Adenocarcinoma: A Decision Analysis in ANNALS OF SURGICAL ONCOLOGY
  • 2016-11-28. CT evaluation after neoadjuvant FOLFIRINOX chemotherapy for borderline and locally advanced pancreatic adenocarcinoma in EUROPEAN RADIOLOGY
  • 2019-12-17. Impact of Neoadjuvant Therapy in Resected Pancreatic Ductal Adenocarcinoma of the Pancreatic Body or Tail on Surgical and Oncological Outcome: A Propensity-Score Matched Multicenter Study in ANNALS OF SURGICAL ONCOLOGY
  • 2013-10-29. Role of Radical Antegrade Modular Pancreatosplenectomy for Adenocarcinoma of the Body and Tail of the Pancreas in WORLD JOURNAL OF SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-021-10560-7

    DOI

    http://dx.doi.org/10.1245/s10434-021-10560-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1140467559

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34403004


    Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
    Incoming Citations Browse incoming citations for this publication using opencitations.net

    JSON-LD is the canonical representation for SciGraph data.

    TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

    [
      {
        "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
        "about": [
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Medical and Health Sciences", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1112", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Oncology and Carcinogenesis", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Adenocarcinoma", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Carcinoma, Pancreatic Ductal", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Humans", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Neoadjuvant Therapy", 
            "type": "DefinedTerm"
          }, 
          {
            "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
            "name": "Pancreatic Neoplasms", 
            "type": "DefinedTerm"
          }
        ], 
        "author": [
          {
            "affiliation": {
              "alternateName": "Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.26999.3d", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
                "Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Watanabe", 
            "givenName": "Genki", 
            "id": "sg:person.014043100545.37", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014043100545.37"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Ushida", 
            "givenName": "Yuta", 
            "id": "sg:person.015750677122.25", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015750677122.25"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Oba", 
            "givenName": "Atsushi", 
            "id": "sg:person.014215735464.23", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014215735464.23"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Ono", 
            "givenName": "Yoshihiro", 
            "id": "sg:person.01240213665.21", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01240213665.21"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Sato", 
            "givenName": "Takafumi", 
            "id": "sg:person.013042551555.87", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013042551555.87"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Inoue", 
            "givenName": "Yosuke", 
            "id": "sg:person.0770623646.53", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0770623646.53"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Takahashi", 
            "givenName": "Yu", 
            "id": "sg:person.01307772440.53", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01307772440.53"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.258269.2", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
                "Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Saiura", 
            "givenName": "Akio", 
            "id": "sg:person.0612301703.87", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0612301703.87"
            ], 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan", 
              "id": "http://www.grid.ac/institutes/grid.486756.e", 
              "name": [
                "Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Ito", 
            "givenName": "Hiromichi", 
            "id": "sg:person.011406547173.21", 
            "sameAs": [
              "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.011406547173.21"
            ], 
            "type": "Person"
          }
        ], 
        "citation": [
          {
            "id": "sg:pub.10.1007/s11605-017-3421-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1084760105", 
              "https://doi.org/10.1007/s11605-017-3421-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1245/s10434-019-08137-6", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1123472879", 
              "https://doi.org/10.1245/s10434-019-08137-6"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00423-019-01767-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1112400449", 
              "https://doi.org/10.1007/s00423-019-01767-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00268-013-2254-8", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1040363068", 
              "https://doi.org/10.1007/s00268-013-2254-8"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1245/s10434-019-07309-8", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1112739381", 
              "https://doi.org/10.1245/s10434-019-07309-8"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00330-016-4632-8", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1051767111", 
              "https://doi.org/10.1007/s00330-016-4632-8"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1245/s10434-015-4711-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1052996982", 
              "https://doi.org/10.1245/s10434-015-4711-0"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1016/j.gassur.2003.08.004", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1029939584", 
              "https://doi.org/10.1016/j.gassur.2003.08.004"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1245/s10434-018-6765-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1107085204", 
              "https://doi.org/10.1245/s10434-018-6765-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1245/s10434-016-5675-4", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1002862157", 
              "https://doi.org/10.1245/s10434-016-5675-4"
            ], 
            "type": "CreativeWork"
          }
        ], 
        "datePublished": "2021-08-17", 
        "datePublishedReg": "2021-08-17", 
        "description": "BackgroundNeoadjuvant therapy is used for borderline resectable pancreatic ductal adenocarcinoma (PDAC) with high risk of incomplete resection and early recurrence. Because distal PDAC is rare, the optimal criteria for neoadjuvant therapy specific for distal PDAC remain unclear. We hypothesized large distal PDAC would recur earlier than small distal PDAC.ObjectiveThe aim of this study was to identify the risk factors for failure of upfront resection for resectable distal PDAC.MethodsThe study cohort comprised 158 patients with resectable distal PDAC who underwent radical resection. The long-term outcomes were recurrence-free survival (RFS), disease-specific survival (DSS), and post-recurrence survival (PRS).ResultsR0 resection was achieved in 92% of patients, and median DSS for the entire cohort was 31 months. Among 103 patients who developed recurrence, 32 (31%) developed recurrence within 6 months. The median PRS and DSS for those with early recurrence was 6 and 10 months, respectively, compared with 11 and 30 months, respectively, for those with late recurrence (p\u00a0=\u00a00.017 and p\u00a0<\u00a00.001, respectively). Patients with tumors >\u20094\u00a0cm had higher rates of R1 resection (16%) and concomitant resection of another organ (19%) than those with smaller tumors (4% and 2%, p\u00a0=\u00a00.009 and p\u00a0<\u00a00.001, respectively). In multivariate analysis, tumor >\u20094\u00a0cm remained a significant predictor of early recurrence (p\u00a0<\u00a00.001, hazard ratio [HR] 6.51), shorter RFS (p\u00a0=\u00a00.018, HR 1.71), and shorter DSS (p\u00a0=\u00a00.002, HR 2.07).ConclusionTumor size >\u20094\u00a0cm is a reliable predictor of early recurrence after resection of distal PDAC, and neoadjuvant therapy may help select patients who can benefit from radical resection.", 
        "genre": "article", 
        "id": "sg:pub.10.1245/s10434-021-10560-7", 
        "isAccessibleForFree": false, 
        "isPartOf": [
          {
            "id": "sg:journal.1105545", 
            "issn": [
              "1068-9265", 
              "1534-4681"
            ], 
            "name": "Annals of Surgical Oncology", 
            "publisher": "Springer Nature", 
            "type": "Periodical"
          }, 
          {
            "issueNumber": "1", 
            "type": "PublicationIssue"
          }, 
          {
            "type": "PublicationVolume", 
            "volumeNumber": "29"
          }
        ], 
        "keywords": [
          "distal pancreatic ductal adenocarcinoma", 
          "disease-specific survival", 
          "pancreatic ductal adenocarcinoma", 
          "post-recurrence survival", 
          "recurrence-free survival", 
          "early recurrence", 
          "radical resection", 
          "neoadjuvant therapy", 
          "borderline resectable pancreatic ductal adenocarcinoma", 
          "median post-recurrence survival", 
          "median disease-specific survival", 
          "shorter disease-specific survival", 
          "resectable pancreatic ductal adenocarcinoma", 
          "shorter recurrence-free survival", 
          "MethodsThe study cohort", 
          "distal pancreatic cancer", 
          "outcomes of patients", 
          "long-term outcomes", 
          "BackgroundNeoadjuvant therapy", 
          "ResultsR0 resection", 
          "R1 resection", 
          "upfront resection", 
          "concomitant resection", 
          "incomplete resection", 
          "study cohort", 
          "late recurrence", 
          "entire cohort", 
          "tumor size", 
          "ConclusionTumor size", 
          "risk factors", 
          "pancreatic cancer", 
          "ductal adenocarcinoma", 
          "small tumors", 
          "resection", 
          "high risk", 
          "patients", 
          "recurrence", 
          "multivariate analysis", 
          "therapy", 
          "tumors", 
          "months", 
          "significant predictors", 
          "reliable predictor", 
          "survival", 
          "cohort", 
          "high rate", 
          "outcomes", 
          "predictors", 
          "adenocarcinoma", 
          "cancer", 
          "risk", 
          "organs", 
          "failure", 
          "aim", 
          "optimal criteria", 
          "factors", 
          "criteria", 
          "study", 
          "rate", 
          "impact", 
          "size", 
          "analysis", 
          "series", 
          "lessons"
        ], 
        "name": "Impact of Tumor Size on the Outcomes of Patients with Resectable Distal Pancreatic Cancer: Lessons Learned from a Series of 158 Radical Resections", 
        "pagination": "378-388", 
        "productId": [
          {
            "name": "dimensions_id", 
            "type": "PropertyValue", 
            "value": [
              "pub.1140467559"
            ]
          }, 
          {
            "name": "doi", 
            "type": "PropertyValue", 
            "value": [
              "10.1245/s10434-021-10560-7"
            ]
          }, 
          {
            "name": "pubmed_id", 
            "type": "PropertyValue", 
            "value": [
              "34403004"
            ]
          }
        ], 
        "sameAs": [
          "https://doi.org/10.1245/s10434-021-10560-7", 
          "https://app.dimensions.ai/details/publication/pub.1140467559"
        ], 
        "sdDataset": "articles", 
        "sdDatePublished": "2022-09-02T16:07", 
        "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
        "sdPublisher": {
          "name": "Springer Nature - SN SciGraph project", 
          "type": "Organization"
        }, 
        "sdSource": "s3://com-springernature-scigraph/baseset/20220902/entities/gbq_results/article/article_904.jsonl", 
        "type": "ScholarlyArticle", 
        "url": "https://doi.org/10.1245/s10434-021-10560-7"
      }
    ]
     

    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1245/s10434-021-10560-7'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1245/s10434-021-10560-7'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1245/s10434-021-10560-7'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1245/s10434-021-10560-7'


     

    This table displays all metadata directly associated to this object as RDF triples.

    249 TRIPLES      21 PREDICATES      104 URIs      86 LITERALS      12 BLANK NODES

    Subject Predicate Object
    1 sg:pub.10.1245/s10434-021-10560-7 schema:about N479b1c7808b24c2780444bc8d2c14e35
    2 N5d34691d782844a8bf334c0acd919c86
    3 Na712d210a22b4dffa3ea9a81473e0517
    4 Nef046eedee53401e977cb1f13d3d8646
    5 Nf91a9b69f4ab44c2b6ed5789514713ce
    6 anzsrc-for:11
    7 anzsrc-for:1112
    8 schema:author N1a72ed99d00645dc976069e93bea99fc
    9 schema:citation sg:pub.10.1007/s00268-013-2254-8
    10 sg:pub.10.1007/s00330-016-4632-8
    11 sg:pub.10.1007/s00423-019-01767-0
    12 sg:pub.10.1007/s11605-017-3421-2
    13 sg:pub.10.1016/j.gassur.2003.08.004
    14 sg:pub.10.1245/s10434-015-4711-0
    15 sg:pub.10.1245/s10434-016-5675-4
    16 sg:pub.10.1245/s10434-018-6765-2
    17 sg:pub.10.1245/s10434-019-07309-8
    18 sg:pub.10.1245/s10434-019-08137-6
    19 schema:datePublished 2021-08-17
    20 schema:datePublishedReg 2021-08-17
    21 schema:description BackgroundNeoadjuvant therapy is used for borderline resectable pancreatic ductal adenocarcinoma (PDAC) with high risk of incomplete resection and early recurrence. Because distal PDAC is rare, the optimal criteria for neoadjuvant therapy specific for distal PDAC remain unclear. We hypothesized large distal PDAC would recur earlier than small distal PDAC.ObjectiveThe aim of this study was to identify the risk factors for failure of upfront resection for resectable distal PDAC.MethodsThe study cohort comprised 158 patients with resectable distal PDAC who underwent radical resection. The long-term outcomes were recurrence-free survival (RFS), disease-specific survival (DSS), and post-recurrence survival (PRS).ResultsR0 resection was achieved in 92% of patients, and median DSS for the entire cohort was 31 months. Among 103 patients who developed recurrence, 32 (31%) developed recurrence within 6 months. The median PRS and DSS for those with early recurrence was 6 and 10 months, respectively, compared with 11 and 30 months, respectively, for those with late recurrence (p = 0.017 and p < 0.001, respectively). Patients with tumors > 4 cm had higher rates of R1 resection (16%) and concomitant resection of another organ (19%) than those with smaller tumors (4% and 2%, p = 0.009 and p < 0.001, respectively). In multivariate analysis, tumor > 4 cm remained a significant predictor of early recurrence (p < 0.001, hazard ratio [HR] 6.51), shorter RFS (p = 0.018, HR 1.71), and shorter DSS (p = 0.002, HR 2.07).ConclusionTumor size > 4 cm is a reliable predictor of early recurrence after resection of distal PDAC, and neoadjuvant therapy may help select patients who can benefit from radical resection.
    22 schema:genre article
    23 schema:isAccessibleForFree false
    24 schema:isPartOf N392230beaa53421ebe199f4a2b23c2f8
    25 Na7d4081bc1424de689f0c60d5461f729
    26 sg:journal.1105545
    27 schema:keywords BackgroundNeoadjuvant therapy
    28 ConclusionTumor size
    29 MethodsThe study cohort
    30 R1 resection
    31 ResultsR0 resection
    32 adenocarcinoma
    33 aim
    34 analysis
    35 borderline resectable pancreatic ductal adenocarcinoma
    36 cancer
    37 cohort
    38 concomitant resection
    39 criteria
    40 disease-specific survival
    41 distal pancreatic cancer
    42 distal pancreatic ductal adenocarcinoma
    43 ductal adenocarcinoma
    44 early recurrence
    45 entire cohort
    46 factors
    47 failure
    48 high rate
    49 high risk
    50 impact
    51 incomplete resection
    52 late recurrence
    53 lessons
    54 long-term outcomes
    55 median disease-specific survival
    56 median post-recurrence survival
    57 months
    58 multivariate analysis
    59 neoadjuvant therapy
    60 optimal criteria
    61 organs
    62 outcomes
    63 outcomes of patients
    64 pancreatic cancer
    65 pancreatic ductal adenocarcinoma
    66 patients
    67 post-recurrence survival
    68 predictors
    69 radical resection
    70 rate
    71 recurrence
    72 recurrence-free survival
    73 reliable predictor
    74 resectable pancreatic ductal adenocarcinoma
    75 resection
    76 risk
    77 risk factors
    78 series
    79 shorter disease-specific survival
    80 shorter recurrence-free survival
    81 significant predictors
    82 size
    83 small tumors
    84 study
    85 study cohort
    86 survival
    87 therapy
    88 tumor size
    89 tumors
    90 upfront resection
    91 schema:name Impact of Tumor Size on the Outcomes of Patients with Resectable Distal Pancreatic Cancer: Lessons Learned from a Series of 158 Radical Resections
    92 schema:pagination 378-388
    93 schema:productId N6db713e37b124713ad22b68d77fe64ac
    94 N6e85a757832d463696f29a18657392e0
    95 Na49bbea4cdf8479aad3ec29466c5638a
    96 schema:sameAs https://app.dimensions.ai/details/publication/pub.1140467559
    97 https://doi.org/10.1245/s10434-021-10560-7
    98 schema:sdDatePublished 2022-09-02T16:07
    99 schema:sdLicense https://scigraph.springernature.com/explorer/license/
    100 schema:sdPublisher N74ed5a7096454ab0a3f1cbcc805090b7
    101 schema:url https://doi.org/10.1245/s10434-021-10560-7
    102 sgo:license sg:explorer/license/
    103 sgo:sdDataset articles
    104 rdf:type schema:ScholarlyArticle
    105 N14913d2942cd49a589a3bb2af2c8d6e2 rdf:first sg:person.014215735464.23
    106 rdf:rest N2abb6c2aa6e64cfaa8de0685e3f7f665
    107 N162c6a74cd9249e490f24767e12b3817 rdf:first sg:person.011406547173.21
    108 rdf:rest rdf:nil
    109 N1a72ed99d00645dc976069e93bea99fc rdf:first sg:person.014043100545.37
    110 rdf:rest Nb12df37d6d79437f8eaddb15a2525eec
    111 N2abb6c2aa6e64cfaa8de0685e3f7f665 rdf:first sg:person.01240213665.21
    112 rdf:rest N3feedd25b1194cd1a221a573cddf043b
    113 N392230beaa53421ebe199f4a2b23c2f8 schema:volumeNumber 29
    114 rdf:type schema:PublicationVolume
    115 N3feedd25b1194cd1a221a573cddf043b rdf:first sg:person.013042551555.87
    116 rdf:rest Nbe405ee41fa04abdb30ec33e7b64d2c9
    117 N479b1c7808b24c2780444bc8d2c14e35 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    118 schema:name Neoadjuvant Therapy
    119 rdf:type schema:DefinedTerm
    120 N5d34691d782844a8bf334c0acd919c86 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    121 schema:name Carcinoma, Pancreatic Ductal
    122 rdf:type schema:DefinedTerm
    123 N6199871a553e4cdf9606f68b37472095 rdf:first sg:person.0612301703.87
    124 rdf:rest N162c6a74cd9249e490f24767e12b3817
    125 N6db713e37b124713ad22b68d77fe64ac schema:name dimensions_id
    126 schema:value pub.1140467559
    127 rdf:type schema:PropertyValue
    128 N6e85a757832d463696f29a18657392e0 schema:name pubmed_id
    129 schema:value 34403004
    130 rdf:type schema:PropertyValue
    131 N74ed5a7096454ab0a3f1cbcc805090b7 schema:name Springer Nature - SN SciGraph project
    132 rdf:type schema:Organization
    133 Na49bbea4cdf8479aad3ec29466c5638a schema:name doi
    134 schema:value 10.1245/s10434-021-10560-7
    135 rdf:type schema:PropertyValue
    136 Na712d210a22b4dffa3ea9a81473e0517 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    137 schema:name Humans
    138 rdf:type schema:DefinedTerm
    139 Na7d4081bc1424de689f0c60d5461f729 schema:issueNumber 1
    140 rdf:type schema:PublicationIssue
    141 Nb12df37d6d79437f8eaddb15a2525eec rdf:first sg:person.015750677122.25
    142 rdf:rest N14913d2942cd49a589a3bb2af2c8d6e2
    143 Nbbae393d5ad54446bd9e87a81f1f3d8c rdf:first sg:person.01307772440.53
    144 rdf:rest N6199871a553e4cdf9606f68b37472095
    145 Nbe405ee41fa04abdb30ec33e7b64d2c9 rdf:first sg:person.0770623646.53
    146 rdf:rest Nbbae393d5ad54446bd9e87a81f1f3d8c
    147 Nef046eedee53401e977cb1f13d3d8646 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    148 schema:name Adenocarcinoma
    149 rdf:type schema:DefinedTerm
    150 Nf91a9b69f4ab44c2b6ed5789514713ce schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
    151 schema:name Pancreatic Neoplasms
    152 rdf:type schema:DefinedTerm
    153 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
    154 schema:name Medical and Health Sciences
    155 rdf:type schema:DefinedTerm
    156 anzsrc-for:1112 schema:inDefinedTermSet anzsrc-for:
    157 schema:name Oncology and Carcinogenesis
    158 rdf:type schema:DefinedTerm
    159 sg:journal.1105545 schema:issn 1068-9265
    160 1534-4681
    161 schema:name Annals of Surgical Oncology
    162 schema:publisher Springer Nature
    163 rdf:type schema:Periodical
    164 sg:person.011406547173.21 schema:affiliation grid-institutes:grid.486756.e
    165 schema:familyName Ito
    166 schema:givenName Hiromichi
    167 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.011406547173.21
    168 rdf:type schema:Person
    169 sg:person.01240213665.21 schema:affiliation grid-institutes:grid.486756.e
    170 schema:familyName Ono
    171 schema:givenName Yoshihiro
    172 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01240213665.21
    173 rdf:type schema:Person
    174 sg:person.013042551555.87 schema:affiliation grid-institutes:grid.486756.e
    175 schema:familyName Sato
    176 schema:givenName Takafumi
    177 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013042551555.87
    178 rdf:type schema:Person
    179 sg:person.01307772440.53 schema:affiliation grid-institutes:grid.486756.e
    180 schema:familyName Takahashi
    181 schema:givenName Yu
    182 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01307772440.53
    183 rdf:type schema:Person
    184 sg:person.014043100545.37 schema:affiliation grid-institutes:grid.26999.3d
    185 schema:familyName Watanabe
    186 schema:givenName Genki
    187 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014043100545.37
    188 rdf:type schema:Person
    189 sg:person.014215735464.23 schema:affiliation grid-institutes:grid.486756.e
    190 schema:familyName Oba
    191 schema:givenName Atsushi
    192 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014215735464.23
    193 rdf:type schema:Person
    194 sg:person.015750677122.25 schema:affiliation grid-institutes:grid.486756.e
    195 schema:familyName Ushida
    196 schema:givenName Yuta
    197 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015750677122.25
    198 rdf:type schema:Person
    199 sg:person.0612301703.87 schema:affiliation grid-institutes:grid.258269.2
    200 schema:familyName Saiura
    201 schema:givenName Akio
    202 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0612301703.87
    203 rdf:type schema:Person
    204 sg:person.0770623646.53 schema:affiliation grid-institutes:grid.486756.e
    205 schema:familyName Inoue
    206 schema:givenName Yosuke
    207 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0770623646.53
    208 rdf:type schema:Person
    209 sg:pub.10.1007/s00268-013-2254-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040363068
    210 https://doi.org/10.1007/s00268-013-2254-8
    211 rdf:type schema:CreativeWork
    212 sg:pub.10.1007/s00330-016-4632-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1051767111
    213 https://doi.org/10.1007/s00330-016-4632-8
    214 rdf:type schema:CreativeWork
    215 sg:pub.10.1007/s00423-019-01767-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1112400449
    216 https://doi.org/10.1007/s00423-019-01767-0
    217 rdf:type schema:CreativeWork
    218 sg:pub.10.1007/s11605-017-3421-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1084760105
    219 https://doi.org/10.1007/s11605-017-3421-2
    220 rdf:type schema:CreativeWork
    221 sg:pub.10.1016/j.gassur.2003.08.004 schema:sameAs https://app.dimensions.ai/details/publication/pub.1029939584
    222 https://doi.org/10.1016/j.gassur.2003.08.004
    223 rdf:type schema:CreativeWork
    224 sg:pub.10.1245/s10434-015-4711-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052996982
    225 https://doi.org/10.1245/s10434-015-4711-0
    226 rdf:type schema:CreativeWork
    227 sg:pub.10.1245/s10434-016-5675-4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002862157
    228 https://doi.org/10.1245/s10434-016-5675-4
    229 rdf:type schema:CreativeWork
    230 sg:pub.10.1245/s10434-018-6765-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1107085204
    231 https://doi.org/10.1245/s10434-018-6765-2
    232 rdf:type schema:CreativeWork
    233 sg:pub.10.1245/s10434-019-07309-8 schema:sameAs https://app.dimensions.ai/details/publication/pub.1112739381
    234 https://doi.org/10.1245/s10434-019-07309-8
    235 rdf:type schema:CreativeWork
    236 sg:pub.10.1245/s10434-019-08137-6 schema:sameAs https://app.dimensions.ai/details/publication/pub.1123472879
    237 https://doi.org/10.1245/s10434-019-08137-6
    238 rdf:type schema:CreativeWork
    239 grid-institutes:grid.258269.2 schema:alternateName Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan
    240 schema:name Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan
    241 Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
    242 rdf:type schema:Organization
    243 grid-institutes:grid.26999.3d schema:alternateName Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
    244 schema:name Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
    245 Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
    246 rdf:type schema:Organization
    247 grid-institutes:grid.486756.e schema:alternateName Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
    248 schema:name Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
    249 rdf:type schema:Organization
     




    Preview window. Press ESC to close (or click here)


    ...