医学
外科肿瘤学
阶段(地层学)
病态的
队列
新辅助治疗
胰腺导管腺癌
腺癌
内科学
肿瘤科
胰腺癌
回顾性队列研究
癌症
放射科
外科
乳腺癌
古生物学
生物
作者
Friedrich Anger,Anna Döring,Jacob L van Dam,Johan Friso Lock,Ingo Klein,Max Bittrich,Christoph‐Thomas Germer,Armin Wiegering,Volker Kunzmann,Casper van Eijck,Stefan Löb
标识
DOI:10.1245/s10434-020-09100-6
摘要
Abstract Background International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important. Methods Patients’ tumours were retrospectively defined borderline resectable according to ICC. The study cohort was grouped into either BR-A or BR-B and compared with patients considered primarily resectable ( R ). Differences in postoperative complications, pathological reports, overall (OS), and disease-free survival were assessed. Results A total of 345 patients underwent resection for PDAC. By applying ICC in routine preoperative assessment, 30 patients were classified as stage BR-A and 62 patients as stage BR-B. In total, 253 patients were considered R . The cohort did not contain BR-C patients. No differences in postoperative complications were detected. Median OS was significantly shorter in BR-A (15 months) and BR-B (12 months) compared with R (20 months) patients (BR-A vs. R : p = 0.09 and BR-B vs. R : p < 0.001). CA19-9, as the determining factor of BR-B patients, turned out to be an independent prognostic risk factor for OS. Conclusions Preoperative staging defining surgical resectability in PDAC according to ICC is crucial for patient survival. Patients with PDAC BR-B should be considered for multimodal neoadjuvant therapy even if considered anatomically resectable.
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