Wu Hsu, Guo Jhe-Cyuan, Yang Shih-Hung, Tien Yu-Wen, Kuo Sung-Hsin
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan.
J Clin Med. 2019 Jul 27;8(8):1115. doi: 10.3390/jcm8081115.
: Pancreatic cancer is a catastrophic disease with high recurrence and death rates, even in early stages. Early detection and early treatment improve survival in many cancer types but have not yet been clearly documented to do so in pancreatic cancer. In this study, we assessed the benefit on survival resulting from different patterns of surveillance in daily practice after curative surgery of early pancreatic cancer. : Patients with pancreatic ductal adenocarcinoma who had received curative surgery between January 2000 and December 2013 at our institute were retrospectively reviewed. Patients were classified into one of four groups, based on surveillance strategy: the symptom group, the imaging group, the marker group (carbohydrate antigen 19-9 and/or carcinoembryonic antigen), and the intense group (both imaging and tumor marker assessment). Overall survival (OS), relapse-free survival (RFS), and post-recurrence overall survival (PROS) were evaluated. : One hundred and eighty-one patients with documented recurrence or metastasis were included in our analysis. The median OS for patients in the symptom group, imaging group, marker group, and intense group were 21.4 months, 13.9 months, 20.5 months, and 16.5 months, respectively ( = 0.670). Surveillance with imaging, tumor markers, or both was not an independent risk factor for OS in univariate and multivariate analyses. There was no significant difference in median RFS (symptom group, 11.7 months; imaging group, 6.3 months; marker group, 9.3 months; intense group, 6.9 months; = 0.259) or median PROS (symptom group, 6.9 months; imaging group, 7.5 months; marker group, 5.0 months; intense group, 7.8 months; = 0.953) between the four groups. Multivariate analyses identified poor Eastern Cooperative Oncology Group Performance Status (ECOG PS) (≥1), primary tumor site (tail), and tumor grade (poor differentiation) were poor prognostic factors for OS. : Surveillance with regular imaging, tumor marker, or both was not an independent risk factor for OS of pancreatic cancer patients who undergo curative tumor resection.
胰腺癌是一种灾难性疾病，即使在早期阶段，其复发率和死亡率也很高。早期发现和早期治疗可提高许多癌症类型的生存率，但在胰腺癌中尚未得到明确证实。在本研究中，我们评估了早期胰腺癌根治性手术后日常实践中不同监测模式对生存的益处。：回顾性分析了2000年1月至2013年12月在我院接受根治性手术的胰腺导管腺癌患者。根据监测策略，患者被分为四组之一：症状组、影像学组、标志物组（糖类抗原19-9和/或癌胚抗原）和强化组（影像学和肿瘤标志物评估均进行）。评估了总生存期（OS）、无复发生存期（RFS）和复发后总生存期（PROS）。：181例有复发或转移记录的患者纳入我们的分析。症状组、影像学组、标志物组和强化组患者的中位OS分别为21.4个月、13.9个月、20.5个月和16.5个月（=0.670）。在单因素和多因素分析中，影像学、肿瘤标志物或两者联合监测均不是OS的独立危险因素。四组之间的中位RFS（症状组，11.7个月；影像学组，6.3个月；标志物组，9.3个月；强化组，6.9个月；=0.259）或中位PROS（症状组，6.9个月；影像学组，7.5个月；标志物组，5.0个月；强化组，7.8个月；=0.953）无显著差异。多因素分析确定东部肿瘤协作组体能状态（ECOG PS）差（≥1）、原发肿瘤部位（胰尾）和肿瘤分级（低分化）是OS的不良预后因素。：对于接受根治性肿瘤切除的胰腺癌患者，定期进行影像学、肿瘤标志物或两者联合监测不是OS的独立危险因素。
