Jacobsen Anne, Flessa Maarten, Abels Anna-Lena, Czubayko Franziska, Mittelstädt Anke, Krautz Christian, Weber Georg F, Grützmann Robert, Brunner Maximilian
Department of General and Visceral Surgery, University Hospital Erlangen, Friedrich-Alexander-University (FAU), 91054 Erlangen, Germany.
Cancers (Basel). 2025 Apr 24;17(9):1424. doi: 10.3390/cancers17091424.
This study aimed to investigate whether structured surveillance after resection of PDAC has an impact on survival.
206 patients who underwent PDAC resection at the University Hospital Erlangen between 2005 and 2020 and survived for at least 90 days postoperatively were included in this retrospective study. The impact of surveillance (structured vs. no structured surveillance) respectively of recurrence patterns (recurrence in follow-up vs. symptomatic recurrence) on overall and disease-free survival was investigated.
A total of 157 patients (76%) participated in a structured surveillance program after pancreatic resection. During a mean follow-up of 28.5 months, 137 patients (67%) developed recurrence. Patients with structured surveillance showed significantly better outcomes for overall survival after surgery (OSaS: 29.2 months with structured surveillance vs. 16.4 months without, < 0.001), overall survival after recurrence (OSaR: 10.8 months vs. 3.6 months, < 0.001), and disease-free survival (DFS: 14.8 months vs. 11.4 months, = 0.010). In a subgroup analysis of 112 patients with recurrence, survival benefits were observed for those whose recurrence was detected during follow-up compared to those with symptomatic recurrence (OSaS: 24.8 months in the follow-up group vs. 17.2 months in the symptomatic group, < 0.001; OSaR: 12.6 months vs. 6.5 months, < 0.001).
This study provides evidence that structured surveillance after PDAC resection is beneficial for both overall and disease-free survival. However, randomized studies are needed to confirm the positive impact of structured surveillance programs on survival after pancreatic resection.
本研究旨在调查胰腺癌切除术后的结构化监测是否对生存率有影响。
本项回顾性研究纳入了2005年至2020年间在埃尔朗根大学医院接受胰腺癌切除术且术后存活至少90天的206例患者。研究了监测（结构化监测与非结构化监测）以及复发模式（随访期间复发与症状性复发）对总生存期和无病生存期的影响。
共有157例患者（76%）在胰腺切除术后参与了结构化监测计划。在平均28.5个月的随访期间，137例患者（67%）出现复发。接受结构化监测的患者术后总生存期（术后总生存期：结构化监测组为29.2个月，非结构化监测组为16.4个月，<0.001）、复发后总生存期（复发后总生存期：10.8个月对3.6个月，<0.001）和无病生存期（无病生存期：14.8个月对11.4个月，=0.010）均显著更好。在112例复发患者的亚组分析中，与症状性复发患者相比，随访期间发现复发的患者生存获益（术后总生存期：随访组为24.8个月，症状性组为17.2个月，<0.001；复发后总生存期：12.6个月对6.5个月，<0.001）。
本研究提供了证据表明胰腺癌切除术后的结构化监测对总生存期和无病生存期均有益。然而，需要进行随机研究来证实结构化监测计划对胰腺切除术后生存的积极影响。
