Background
Methods
Results
Comparisons of the clinicopathological characteristics of patients who underwent repeat pancreatectomy between pancreaticoduodenectomy and distal pancreatectomy
Clinico-pathological parameters | Operation methods for repeat pancreatectomy | p value | |
---|---|---|---|
PD (n = 8) | DP (n = 20) | ||
Age (years: median ± SD) | 67.5 ± 12 | 68.0 ± 9 | 0.92 |
Sex (M/F) | 4 / 4 | 13 / 7 | 0.46 |
Diagnosis (PC/invasive IPMC) | 6 / 2 | 18 / 2 | 0.31 |
Operation time (min: median ± SD) | 427 ± 106 | 200 ± 128 | 0.004* |
Blood volume loss (g: median ± SD) | 1095 ± 886 | 520 ± 4333 | 0.14 |
PVR (+/−) | 4 / 4 | 0 / 20 | 0.0006* |
Arterial resection (+/−) | 1 / 7 | 4 / 16 | 0.64 |
pT (I / II,III,IV) | 2 / 6 | 6 / 14 | 0.79 |
pN (0/1) | 5 / 3 | 11 / 9 | 0.72 |
UICC stage-8th (≤ IIA/≥ IIB) | 4 / 4 | 10 / 10 | 0.78 |
DPM at initial operation (+/−) | 2 / 6 | 2 / 18 | 0.31 |
Curability (R0/1) | 7 / 1 | 14 / 6 | 0.33 |
Complications (C-D: ≤ IIb/≥ IIIa) | 6 / 2 | 17 / 3 | 0.53 |
Postoperative hospital stay (days: median ± SD) | 31 ± 9 | 22 ± 10 | 0.0009* |
The frequency and forms of recurrence after repeat pancreatectomy in patients with invasive pancreatic neoplasm
The analyses of pre- and post-operative prognostic factors for cancer-specific survival after repeat pancreatectomy in patients with invasive pancreatic neoplasms
Clinico-pathological parameters | Univariate analysis | ||
---|---|---|---|
n = 28 | HR (95% CI) | p value | |
Age (years: ≥ 68/≤ 67) | 13 / 15 | 0.89 (0.29–2.68) | 0.83 |
Sex (M/F) | 17 / 11 | 1.64 (0.52–6.26) | 0.41 |
Diagnosis at initial operation (PC/IPMN) | 22 / 6 | 4.05 (0.80–73.73) | 0.10 |
DPM at initial operation (+/−) | 4 / 24 | 0.49 (0.03–2.66) | 0.52 |
Recurrence at the margin of initial resection (+/−) | 5 / 23 | 0.27 (0.02–1.43) | 0.14 |
Chemo (radio) Tx after initial diagnosis of recurrence (+/−) | 9 / 19 | 2.76 (0.88–8.35) | 0.08 |
Preoperative CA19–9 (≥ 100/< 100) (U/mL) | 14 / 14 | 0.77 (0.25–2.43) | 0.64 |
NLR (≥ 3.0/< 3.0) | 14 / 14 | 1.36 (0.45–4.51) | 0.59 |
LMR (≥ 3.3/< 3.3) | 20 / 8 | 0.25 (0.08–0.81) | 0.022* |
Intervals from 1st to 2nd operation (≥ 24 m/< 24 m) | 20 / 8 | 0.78 (0.25–2.90) | 0.69 |
Clinico-pathological parameters | Univariate analysis | ||
---|---|---|---|
n = 28 | HR (95% CI) | p value | |
Diagnosis at RP (PC/invasive IPMC) | 24 / 4 | 1.88 (0.37–34.26) | 0.51 |
Operation method (PD/DP) | 8 / 20 | 1.56 (0.42–4.84) | 0.48 |
PVR (+/−) | 4 / 24 | 6.90 (1.39–28.83) | 0.021* |
Arterial resection (+/−) | 5 / 23 | 4.28 (1.10–14.56) | 0.037* |
pT (I / II,III,IV) | 8 / 20 | 0.68 (0.15–2.24) | 0.55 |
pN (+/−) | 12 / 16 | 5.06 (1.59–19.31) | 0.0057* |
Curability (R0/1) | 21 / 7 | 1.11 (0.34–4.94) | 0.88 |
C-D (≤ IIb/≥ IIIa) | 23 / 5 | 0.40 (0.12–1.79) | 0.20 |
Postoperative CA19–9 levels (≥ 37/< 37) (U/mL) | 11 / 17 | 1.81 (0.58–5.46) | 0.30 |
Decrease rate of CA19–9 (≥ 70/< 70) (%) | 14 / 14 | 0.35 (0.09–1.09) | 0.067 |
Adjuvant chemotherapy after RP (+/−) | 17 / 11 | 1.35 (0.43–5.05) | 0.61 |
Clinico-pathological parameters | Multivariate analysis | ||
---|---|---|---|
n = 28 | HR (95% CI) | p value | |
LMR (≥ 3.3/< 3.3) | 20 / 8 | 0.06 (0.01–0.30) | 0.0005* |
PVR (+/−) | 4 / 24 | 3.08 (0.53–17.31) | 0.20 |
Arterial resection (+/−) | 5 / 23 | 1.56 (0.32–7.22) | 0.57 |
pN (+/−) | 12 / 16 | 6.63 (1.37–40.35) | 0.018* |
Decrease rate of CA19–9 (≥ 70/< 70) (%) | 14 / 14 | 0.27 (0.05–1.26) | 0.098 |
The analyses of prognostic factors for cancer-specific survival after repeat pancreatectomy in patients with pancreatic cancer
Clinico-pathological parameters | Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|---|
n = 24 | HR (95% CI) | p value | HR (95% CI) | p value | |
Preoperative CA19–9 (≥ 100/< 100) (U/mL) | 13 / 11 | 0.79 (0.27–2.91) | 0.85 | ||
NLR (≥ 3.0/< 3.0) | 14 / 10 | 0.94 (0.30–3.20) | 0.92 | ||
LMR (≥ 3.3/< 3.3) | 16 / 8 | 0.27 (0.08–0.89) | 0.033* | 0.07 (0.01–0.37) | 0.0013* |
Intervals from 1st to 2nd operation (≥ 24 m/< 24 m) | 17 / 7 | 0.59 (0.18–2.21) | 0.40 | ||
PVR (+/−) | 3 / 21 | 7.84 (1.53–36.03) | 0.017* | 3.86 (0.62–25.72) | 0.14 |
Arterial resection (+/−) | 5 / 19 | 4.20 (1.05–15.19) | 0.043* | 1.90 (0.38–9.66) | 0.43 |
pN (+/−) | 10 / 14 | 4.12 (1.26–15.90) | 0.019* | 5.53 (1.04–37.45) | 0.045* |
Curability (R0/1) | 17 / 7 | 1.20 (0.36–5.44) | 0.78 | ||
Postoperative CA19–9 (≥ 37/< 37) (U/mL) | 10 / 14 | 1.74 (0.54–5.58) | 0.34 | ||
Decrease rate of CA19–9 (≥ 70/< 70) (%) | 13 / 11 | 0.37 (0.10–1.18) | 0.093 | 0.32 (0.05–1.56) | 0.16 |
Adjuvant chemotherapy after RP (+/−) | 16 / 8 | 0.88 (0.27–3.36) | 0.84 |