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Daamen, L.A.; Dorland, G.; Brada, L.J.H.; Groot, V.P.; Oosten, A.F. van; Besselink, M.G.; ... ; Dutch Pancreatic Canc Grp (2022)

Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma

Article in monograph or in proceedings
Background: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy. Methods: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection. Results: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) < 3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence < 3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90 degrees...Show moreBackground: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy. Methods: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection. Results: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) < 3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence < 3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90 degrees venous involvement on CT imaging (OR 2.93 [95% CI 1.60-5.37]; P < 0.001) were associated with recurrence within 3-6 months. A Charlson Age Comorbidity Index > 4 (OR 1.53 [95% CI 1.09-2.16]; P = 0.02) and logCA 19-9 (OR 1.24 [95% CI 1.14-1.35]; P < 0.001) were related to recurrence within 6-12 months. Conclusion: This study demonstrates preoperative predictors that are associated with the manifestation of early and very early recurrence after PDAC resection. Knowledge of these predictors can be used to guide individualized surveillance and treatment strategies.Show less
All authors
Daamen, L.A.; Dorland, G.; Brada, L.J.H.; Groot, V.P.; Oosten, A.F. van; Besselink, M.G.; Bosscha, K.; Bonsing, B.A.; Busch, O.R.; Cirkel, G.A.; Dam, R.M. van; Festen, S.; Koerkamp, B.G.; Mohammad, N.H.; Harst, E. van der; Hingh, I.H.J.T. de; Intven, M.P.W.; Kazemier, G.; M. los; Meijer, V.E. de; Nieuwenhuijs, V.B.; Roos, D.; Schreinemakers, J.M.J.; Stommel, M.W.J.; Verdonk, R.C.; Verkooijen, H.M.; Molenaar, I.Q.; Santvoort, H.C. van; Dutch Pancreatic Canc Grp
Date
2022-04-13
Title of host publication
HPB
Volume
24
Issue
4
Pages
535 - 546
DOI
doi:10.1016/j.hpb.2021.09.004