HIGUCHI Ryota
   Department   School of Medicine(Yachiyo Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Evaluation of preoperative prognostic factors in patients with resectable invasive intraductal papillary mucinous carcinoma.
Journal Formal name：Surgery
Abbreviation：Surgery
ISSN code：15327361/00396060
Domestic / ForeginForegin
Volume, Issue, Page 168(6),pp.994-1002
Author and coauthor IZUMO Wataru†, HIGUCHI Ryota, FURUKAWA Toru, YAZAWA Takehisa, UEMURA Shuichiro, SHIIHARA Masahiro, YAMAMOTO Masakazu
Authorship 2nd author
Publication date 2020/12
Summary 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