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Risk Stratification of Pancreatic Ductal Adenocarcinoma Patients Undergoing Curative-Intent Surgery after Neoadjuvant Therapy
DC Field | Value | Language |
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dc.contributor.author | 강창무 | - |
dc.contributor.author | 김명진 | - |
dc.contributor.author | 박미숙 | - |
dc.contributor.author | 방승민 | - |
dc.contributor.author | 성진실 | - |
dc.contributor.author | 양현경 | - |
dc.contributor.author | 정용은 | - |
dc.contributor.author | 최진영 | - |
dc.contributor.author | 한경화 | - |
dc.date.accessioned | 2024-03-22T06:34:21Z | - |
dc.date.available | 2024-03-22T06:34:21Z | - |
dc.date.issued | 2024-01 | - |
dc.identifier.issn | 1598-2998 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/198572 | - |
dc.description.abstract | Purpose Clinical prognostic criteria using preoperative factors were not developed for post–neoadjuvant therapy (NAT) surgery of pancreatic ductal adenocarcinoma (PDAC). We aimed to identify preoperative factors associated with overall survival (OS) in PDAC patients who underwent post-NAT curative-intent surgery and develop risk stratification criteria.Materials and Methods Consecutive PDAC patients who underwent post-NAT curative-intent surgeries between 2007 and 2020 were retrospectively analyzed. Demographic, laboratory, surgical, and histopathologic variables were collected. Baseline, preoperative, and interval changes of computed tomography (CT) findings proposed by the Society of Abdominal Radiology and the American Pancreatic Association were analyzed. Cox proportional hazard analysis was used to select preoperative variables associated with OS. We developed risk stratification criteria composed of the significant preoperative variables, i.e., post-NAT response criteria. We compared the discrimination performance of post-NAT response criteria with that of post-NAT pathological (yp) American Joint Cancer Committee TNM staging system.Results One hundred forty-five PDAC patients were included. Stable or increased tumor size on CT (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.58 to 4.21; p < 0.001) and elevated preoperative carbohydrate antigen 19-9 (CA19-9) level (HR, 1.98; 95% CI, 1.11 to 3.55; p=0.021) were independent factors of OS. The OS of the patient groups stratified by post-NAT response criteria which combined changes in tumor size and CA19-9 showed significant difference (p < 0.001). Such stratification was comparable to ypTNM staging in discrimination performance (difference of C-index, 0.068; 95% CI, –0.012 to 0.142).Conclusion “Any degree of decrease in tumor size on CT” and CA19-9 normalization or staying normal were independent favorable factors of OS. The combination of the two factors discriminated OS comparably to ypTNM staging. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English, Korean | - |
dc.publisher | Official journal of Korean Cancer Association | - |
dc.relation.isPartOf | CANCER RESEARCH AND TREATMENT | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | CA-19-9 Antigen | - |
dc.subject.MESH | Carcinoma, Pancreatic Ductal* / surgery | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Neoadjuvant Therapy | - |
dc.subject.MESH | Pancreatic Neoplasms* / drug therapy | - |
dc.subject.MESH | Pancreatic Neoplasms* / surgery | - |
dc.subject.MESH | Prognosis | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Risk Assessment | - |
dc.title | Risk Stratification of Pancreatic Ductal Adenocarcinoma Patients Undergoing Curative-Intent Surgery after Neoadjuvant Therapy | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Surgery (외과학교실) | - |
dc.contributor.googleauthor | Hyun Kyung Yang | - |
dc.contributor.googleauthor | Mi-Suk Park | - |
dc.contributor.googleauthor | Kyunghwa Han | - |
dc.contributor.googleauthor | Geonsik Eom | - |
dc.contributor.googleauthor | Yong Eun Chung | - |
dc.contributor.googleauthor | Jin-Young Choi | - |
dc.contributor.googleauthor | Seungmin Bang | - |
dc.contributor.googleauthor | Chang Moo Kang | - |
dc.contributor.googleauthor | Jinsil Seong | - |
dc.contributor.googleauthor | Myeong-Jin Kim | - |
dc.identifier.doi | 10.4143/crt.2023.586 | - |
dc.contributor.localId | A00088 | - |
dc.contributor.localId | A00426 | - |
dc.contributor.localId | A01463 | - |
dc.contributor.localId | A01786 | - |
dc.contributor.localId | A01956 | - |
dc.contributor.localId | A06172 | - |
dc.contributor.localId | A03662 | - |
dc.contributor.localId | A04200 | - |
dc.contributor.localId | A04267 | - |
dc.relation.journalcode | J00453 | - |
dc.identifier.eissn | 2005-9256 | - |
dc.identifier.pmid | 37605535 | - |
dc.subject.keyword | CA-19-9 antigen | - |
dc.subject.keyword | Neoadjuvant therapy | - |
dc.subject.keyword | Pancreatic ductal carcinoma | - |
dc.subject.keyword | Prognosis | - |
dc.subject.keyword | X-ray computed tomography | - |
dc.contributor.alternativeName | Kang, Chang Moo | - |
dc.contributor.affiliatedAuthor | 강창무 | - |
dc.contributor.affiliatedAuthor | 김명진 | - |
dc.contributor.affiliatedAuthor | 박미숙 | - |
dc.contributor.affiliatedAuthor | 방승민 | - |
dc.contributor.affiliatedAuthor | 성진실 | - |
dc.contributor.affiliatedAuthor | 양현경 | - |
dc.contributor.affiliatedAuthor | 정용은 | - |
dc.contributor.affiliatedAuthor | 최진영 | - |
dc.contributor.affiliatedAuthor | 한경화 | - |
dc.citation.volume | 56 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 247 | - |
dc.citation.endPage | 258 | - |
dc.identifier.bibliographicCitation | CANCER RESEARCH AND TREATMENT, Vol.56(1) : 247-258, 2024-01 | - |
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