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Radiologically occult metastatic pancreatic cancer: how can we avoid unbeneficial resection?

放射学隐匿性转移性胰腺癌: 我们如何避免无益切除?

  • 影响因子:2.30
  • DOI:10.1007/s00423-019-01846-2
  • 作者列表:"Oba, Atsushi","Inoue, Yosuke","Ono, Yoshihiro","Irie, Shoichi","Sato, Takafumi","Mise, Yoshihiro","Ito, Hiromichi","Takahashi, Yu","Saiura, Akio
  • 发表时间:2020-02-01
Abstract

Purpose This study aimed to clarify the key factors for minimizing unsuitable surgical interventions for patients with radiologically occult metastatic pancreatic cancer (ROMPC), defined as a distant metastasis detected during surgery or within 6 months after resection. Methods This study involved 502 patients planned to undergo curative resection for pancreatic cancer between 2008 and 2015. Patients were divided into ROMPC and non-ROMPC groups and evaluated preoperative factors associated with ROMPC. Results Overall survival (OS) was significantly lower in the ROMPC group ( n  = 145) than the non-ROMPC group ( n  = 357, median survival time [MST] 10.8 vs. 35.3 months, P  < 0.001). In the ROMPC group, OS tended to be worse for patients who had pancreatectomies ( n  = 84) than those who did not ( n  = 61, MST 10.1 vs. 13.2 months, P  = 0.057), and the next chemotherapy started significantly later in patients who had pancreatectomies ( P  < 0.001). Moreover, OS was significantly lower for patients with ( n  = 82) than without ( n  = 63) liver metastases (MST 9.7 vs. 13.0 months, respectively, P  = 0.020). The best indicator for patients at higher risk of ROMPC was a combination of carbohydrate antigen 19-9 concentration ≥ 300 U/ml and tumor size ≥ 30 mm. Conclusions In the ROMPC group, patients who underwent pancreatectomy had a poorer prognosis than patients not undergoing pancreatectomy. Given that the liver was the most frequent distant metastatic site for ROMPC and had the poorest prognosis, establishing a strategy featuring new imaging modalities to detect radiologically occult liver metastases is necessary.

摘要

目的本研究旨在阐明减少放射学隐匿性转移性胰腺癌 (ROMPC) 患者不适当手术干预的关键因素, 定义为手术期间或切除后 6 个月内发现的远处转移。方法本研究共纳入 502 例计划于 2015 和 2008年进行胰腺癌根治性切除术的患者。将患者分为 ROMPC 组和非 ROMPC 组,评估与 ROMPC 相关的术前因素。结果 ROMPC 组 (n = 145) 的总生存期 (OS) 明显低于非 ROMPC 组 (n = 357, 中位生存时间 [MST] 10.8 vs. 35.3 个月,P  

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影响因子:5.13
发表时间:2020-01-28
DOI:10.1080/17425247.2020.1723544
作者列表:["Kou L","Huang H","Lin X","Jiang X","Bao S","Luo Q","Sun J","Yao Q","Ganapathy V","Chen R"]

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影响因子:2.30
发表时间:2020-01-28
DOI:10.1007/s00423-020-01857-4
作者列表:["Okada KI","Kawai M","Hirono S","Kojima F","Tanioka K","Terada M","Miyazawa M","Kitahata Y","Iwahashi Y","Ueno M","Hayami S","Murata SI","Shimokawa T","Yamaue H"]

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