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ウエムラ シユウイチロウ
Uemura Shiyuuichirou
植村 修一郎 所属 医学部 医学科（東京女子医科大学病院） 職種 助教 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Evaluation of preoperative prognostic factors in patients with resectable invasive intraductal papillary mucinous carcinoma. |
| 掲載誌名 | 正式名：Surgery 略 称：Surgery ISSNコード：15327361/00396060 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 168(6),pp.994-1002 |
| 著者・共著者 | IZUMO Wataru†, HIGUCHI Ryota, FURUKAWA Toru, YAZAWA Takehisa, UEMURA Shuichiro, SHIIHARA Masahiro, YAMAMOTO Masakazu |
| 発行年月 | 2020/12 |
| 概要 | BACKGROUND:Upfront surgery is the standard treatment for resectable invasive intraductal papillary mucinous carcinoma; however, recurrence is common. Therefore, we investigated the recurrence, surgical outcome, and preoperative prognostic factors for recurrence in patients with resectable invasive intraductal papillary mucinous carcinoma.METHODS:We analyzed 111 patients who underwent upfront surgery for resectable invasive intraductal papillary mucinous carcinoma between 2000 and 2017 and evaluated the relationship among clinicopathologic factors, recurrence, and outcomes.RESULTS:The 5-year recurrence-free survival and disease-specific survival rates were 61% and 74%, respectively. The median time to recurrence was 1.1 years. In multivariate analysis, carbohydrate antigen 19-9 ≥83 U/mL (hazard ratio: 2.8 and 3.1), tumor size ≥2.2 cm (hazard ratio: 3.5 and 4.7), and pathologic tubular adenocarcinoma grade 2 (hazard ratio: 3.1 and 5.2) were risk factors for a shorter recurrence-free survival and disease-specific survival, respectively. Lymph node metastasis (hazard ratio: 3.9) was also a risk factor for a shorter disease-specific survival. When examining outcomes according to preoperatively measurable factors (carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm), the 5-year recurrence rates in patients with none (n = 47), 1 (n = 46), and both (n = 18) risk factors were 17%, 48%, and 78%, respectively. Five-year disease-specific survival rates in patients with none, 1, and both preoperative risk factors were 95%, 69%, and 31%, respectively.CONCLUSION:Carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm were independent preoperative risk factors for poor outcomes in patients with resectable invasive intraductal papillary mucinous carcinoma. |
| DOI | 10.1016/j.surg.2020.01.014 |
| PMID | 32139141 |