Erschienen in:
01.09.2023 | Pancreatic Tumors
Impact of Preoperative Tumor Size on Prognosis of Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinomas
verfasst von:
Yoichi Miyata, MD, PhD, Naoto Yonamine, MD, Ibuki Fujinuma, MD, Takazumi Tsunenari, MD, Yasuhiro Takihata, MD, Hiroyuki Hakoda, MD, Akiko Nakazawa, MD, Toshimitsu Iwasaki, MD, PhD, Takahiro Einama, MD, PhD, Junichi Togashi, MD, PhD, Hironori Tsujimoto, MD, PhD, Hideki Ueno, MD, PhD, Yoshifumi Beck, MD, PhD, Yoji Kishi, MD, PhD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 13/2023
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Abstract
Background
Tumor size (TS) is a well-established prognostic factor of pancreatic ductal adenocarcinoma (PDAC). However, whether a uniform treatment strategy can be applied for all resectable PDACs (R-PDACs) and borderline resectable PDACs (BR-PDACs), regardless of TS, remains unclear. This study aimed to investigate the impact of preoperative TS on surgical outcomes of patients with R-PDACs and BR-PDACs.
Methods
Chart data from three institutions were reviewed to select patients who underwent pancreatectomy for R-PDACs and BR-PDACs between January 2006 and December 2020. The patients were divided into TSsmall and TSlarge groups according to a TS cutoff value determined for each of R- and BR-PDAC using the minimum P value approach for the risk of R1 resection.
Results
TS of 35 mm and 24 mm was the best cutoff value in R-PDAC and BR-PDAC, respectively. The R1 rate was higher in the TSlarge than TSsmall group, in both R- (n = 35, 37% versus n = 294, 19%; P = 0.011) and BR-PDAC (n = 89, 37% versus n = 27, 15%; P = 0.030). Overall survival was significantly better in the TSsmall than TSlarge group in R-PDAC (38.2 versus 12.1 months; P < 0.001), but comparable between the two groups in BR-DPAC (21.2 versus 22.7 months; P = 0.363). Multivariate analysis revealed TS > 35 mm as an independent predictor of worse survival in patients with R-PDAC.
Conclusion
Larger TS was associated with a higher R1 rate and is a worse prognostic factor in patients with R-PDAC.