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- W3210266087 abstract "Purpose: To investigate the timing, pattern, and predictors of recurrence in patients receiving pancreatectomy after neoadjuvant treatment (NAT) for resectable and borderline resectable (BR) pancreatic cancer (PDAC). Methods: All pancreatectomies after NAT for resectable and BR-PDAC at two academic institutions were reviewed (2013-2017). ΔCa19.9 was computed as: (baseline Ca19.9–post-treatment Ca19.9)/ baseline Ca19.9. A minimum p-value approach was used for continuous variables categorization. The possible interplay between Ca19.9 parameters and between radiological features was assessed including interaction terms in the multivariable Cox models. Results: The median postoperative follow-up was 24.9 months overall (n=315), 30.8 months in censored cases. The median recurrence-free survival (RFS) was 15.7 months. The estimated recurrence rates were 19.0%-41.9%-51.4%-63.2%-69.1%-24.2% at 6/12/18/24/30/36 months. Survival outcomes varied depending on the recurrence pattern. Differences in RFS between groups were maximized by a threshold of 19 mm in post-treatment tumor size (p= 7.34x10-7), 53.8% in ΔCa19.9 (p=7.26 x 10-4), approximated to 20mm and 50%, respectively. The analysis of RFS predictors is displayed in the Table. When including interactions into the model, that between ΔCa19.9 and post-treatment Ca 19.9 remained significant (HR 0.551, 95%CI 0.364-0.835, p=0.005), suggesting a substantial risk reduction in patients with elevated post-treatment Ca 19.9 values, when the ΔCa19.9 exceeded 50%. Conclusion: In patients receiving pancreatectomy after NAT, postoperative recurrence is frequent (>40% at 1-year). Post-treatment Ca 19.9 normalization, tumor size <20mm, and Ca19.9 decrease ≥50% are independent predictors of RFS. These results have potential implications for surgical decision-making in patients receiving NAT and might help personalized postoperative prognostication." @default.
- W3210266087 created "2021-11-08" @default.
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- W3210266087 date "2021-01-01" @default.
- W3210266087 modified "2023-09-27" @default.
- W3210266087 title "Defining and predicting recurrence in patients undergoing pancreatectomy after neoadjuvant treatment for pancreatic ductal adenocarcinoma" @default.
- W3210266087 doi "https://doi.org/10.1016/j.hpb.2021.08.195" @default.
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