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The Yonsei criteria as a clinically detectable parameter for excellent prognosis in resected left-sided pancreatic cancer: outcomes of a propensity score-matched analysis

Authors
 Sung Hwan Lee  ;  Ho Kyoung Hwang  ;  Chang Moo Kang  ;  Woo Jung Lee 
Citation
 Surgical Endoscopy , Vol.31(11) : 4656-4664, 2017 
Journal Title
 Surgical Endoscopy  
ISSN
 0930-2794 
Issue Date
2017
MeSH
Aged ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Pancreas/pathology* ; Pancreas/surgery ; Pancreatectomy/adverse effects ; Pancreatectomy/methods* ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery* ; Patient Selection ; Prognosis ; Propensity Score ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Keywords
Disease-free survival ; Pancreatic cancer ; Selection criteria
Abstract
BACKGROUND: This study aimed to identify that Yonsei criteria (YC) can be regarded as a preoperative clinical parameter to predict biological behavior of the left-sided pancreatic cancer. METHODS: Between June 2007 and December 2014, 135 patients who underwent minimally invasive (MIS) or open distal pancreatectomy for left-sided pancreatic cancer were enrolled in this study consecutively. Perioperative short-term and long-term oncologic outcomes were analyzed according to the YC retrospectively. RESULTS: Fifty-four and 81 patients did and did not meet the YC, respectively. Short-term oncologic outcomes were favorable among those meeting the YC even after propensity score matching. Patients within the YC also had better disease-free and disease-specific overall survival (p < 0.05). In analysis for receiver operating characteristic curve, area under curve of CA19-9 was satisfactory only within YC group. Multivariate analysis for disease-free survival identified the YC as a strong independent prognostic factor (p < 0.05). In preoperative clinical setting, patients' survival was clearly different based on following clinical groups, such as within YC, beyond YC, and unresectable. CONCLUSIONS: Preoperative CT-based determined YC can predict excellent short-term and long-term oncologic outcomes. YC might have a potential role as a preoperative clinical staging for left-sided pancreatic cancer. External validations of YC based on multicenter cohorts are mandatory to confirm this oncologic significance of YC.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161283
DOI
10.1007/s00464-017-5529-6
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
강창무(Kang, Chang Moo) ; 이성환(Lee, Sung Hwan) ; 이우정(Lee, Woo Jung) ; 황호경(Hwang, Ho Kyoung)
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Full Text
https://link.springer.com/article/10.1007%2Fs00464-017-5529-6
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