Hosokawa Yuichi, Nagakawa Yuichi, Sahara Yatsuka, Takishita Chie, Katsumata Kenji, Tsuchida Akihiko
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Dig Surg. 2017;34(2):125-132. doi: 10.1159/000449041. Epub 2016 Sep 23.
BACKGROUND/AIMS: Curative resection is still the only treatment for patients with pancreatic ductal adenocarcinoma (PDAC). However, early postoperative recurrence occurs frequently. The aim of this study was to investigate the predictors of early recurrence of PDAC.
Clinical data of 172 consecutive patients with PDAC who underwent curative resection (R0) between 2000 and 2015 at Tokyo Medical University Hospital were retrospectively analyzed.
The median follow-up period was 18.2 months. Recurrence occurred in 96 of 172 (55.8%) patients, 27 in whom recurrence occurred within 6 months (early recurrence). Median survival time of the early recurrence group was 10.7 months. The optimal cutoff concentrations for the prediction of early recurrence were 111.3 U/ml, 3.0 ng/ml, 41 U/ml and 670 U/ml for CA19-9, carcinoembryonic antigen, SPan-1 and DUPAN-2, respectively. Multivariate analysis demonstrated that a SPan-1 concentration of >41 U/ml, having received neoadjuvant therapy and having never received adjuvant chemotherapy were significant and independent predictors of early recurrence.
A preoperative SPan-1 concentration of >41 U/ml is a significant and independent predictor of the early recurrence of pancreatic adenocarcinoma.
背景/目的：根治性切除仍是胰腺导管腺癌（PDAC）患者的唯一治疗方法。然而，术后早期复发频繁发生。本研究旨在探讨PDAC早期复发的预测因素。
回顾性分析2000年至2015年在东京医科大学医院接受根治性切除（R0）的172例连续性PDAC患者的临床资料。
中位随访期为18.2个月。172例患者中有96例（55.8%）复发，其中27例在6个月内复发（早期复发）。早期复发组的中位生存时间为10.7个月。CA19-9、癌胚抗原、SPan-1和DUPAN-2预测早期复发的最佳临界浓度分别为111.3 U/ml、3.0 ng/ml、41 U/ml和670 U/ml。多因素分析表明，SPan-1浓度>41 U/ml、接受新辅助治疗且从未接受辅助化疗是早期复发的显著且独立的预测因素。
术前SPan-1浓度>41 U/ml是胰腺腺癌早期复发的显著且独立的预测因素。
