The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy: a single-center and retrospective analysis

Abstract Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma (PDAC) recurrence are unclear. This study attempted to identify the predictive factors for early PDAC recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy. Methods One hundred and fifteen patients undergoing curative resection for PDAC between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did and did not experience PDAC recurrence within 6 months postoperatively. Results Thirty-four (30%) patients experienced early recurrence. Multivariate analyses demonstrated postoperative carbohydrate antigen 19-9 (CA19-9) de-normalization, no postoperative adjuvant chemotherapy (ACT), and serosal invasion were independent risk factors for early recurrence (P<0.001, P=0.001, and P=0.010, respectively). A subgroup analysis showed patients with (n=51) and without (n=64) preoperative chemoradiotherapy (CRT) had different predictors. Although postoperative ACT was not a significant indicator in patients with preoperative CRT, CA19-9 de-normalization and no postoperative ACT were significant indicators in patients without preoperative CRT. Preoperative CRT strongly prevented early local recurrence while postoperative ACT prevented early distant recurrence. Conclusions CA19-9 de-normalization was an important predictor of early recurrence of PDAC. Although postoperative ACT was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative CRT might compensate for a lack of postoperative ACT. Preoperative CRT could strongly prevent the early local recurrence of PDAC. These perioperative adjuvant therapies could have a complementary relationship.

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The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy

BMC Surgery ◽

10.1186/s12893-019-0644-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Hironobu Suto ◽

Keiichi Okano ◽

Minoru Oshima ◽

Yasuhisa Ando ◽

Shigeo Takahashi ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Local Recurrence ◽

Adjuvant Therapy ◽

Pancreatic Ductal Adenocarcinoma ◽

Preoperative Chemoradiotherapy ◽

Distant Recurrence ◽

Early Recurrence ◽

Ductal Adenocarcinoma ◽

Postoperative Adjuvant Chemotherapy ◽

Early Local Recurrence

Abstract Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma recurrence are unclear. This study attempted to identify the predictive factors for early pancreatic ductal adenocarcinoma recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy. Methods One hundred and fifteen patients undergoing curative resection for pancreatic ductal adenocarcinoma between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did (n = 34) and did not (n = 81) experience a recurrence within 6 months postoperatively. Results Multivariate analyses demonstrated postoperative CA19–9 de-normalization, no postoperative adjuvant chemotherapy, and serosal invasion were independent risk factors for early recurrence (P < 0.001, P = 0.001, and P = 0.010, respectively). A subgroup analysis showed patients with (n = 51) and without (n = 64) preoperative chemoradiotherapy had different predictors. Although postoperative adjuvant chemotherapy was not a significant indicator in patients with preoperative chemoradiotherapy, CA19–9 de-normalization and no postoperative adjuvant chemotherapy were significant indicators in patients without preoperative chemotherapy. Preoperative chemotherapy strongly prevented early local recurrence while postoperative adjuvant chemotherapy prevented early distant recurrence. Conclusions CA19–9 de-normalization was an important predictor of early recurrence of pancreatic ductal adenocarcinoma. Although postoperative adjuvant chemotherapy was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative chemoradiotherapy could strongly prevent the early local recurrence of pancreatic ductal adenocarcinoma. These perioperative adjuvant therapies could have a complementary relationship.

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The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy

10.21203/rs.2.11858/v3 ◽

2019 ◽

Author(s):

Hironobu Suto ◽

Keiichi Okano ◽

Minoru Oshima ◽

Yasuhisa Ando ◽

Shigeo Takahashi ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Local Recurrence ◽

Adjuvant Therapy ◽

Pancreatic Ductal Adenocarcinoma ◽

Preoperative Chemoradiotherapy ◽

Distant Recurrence ◽

Early Recurrence ◽

Ductal Adenocarcinoma ◽

Postoperative Adjuvant Chemotherapy ◽

Early Local Recurrence

Abstract Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma recurrence are unclear. This study attempted to identify the predictive factors for early pancreatic ductal adenocarcinoma recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy. Methods One hundred and fifteen patients undergoing curative resection for pancreatic ductal adenocarcinoma between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did (n=34) and did not (n=81) experience a recurrence within 6 months postoperatively. Results Multivariate analyses demonstrated postoperative CA19-9 de-normalization, no postoperative adjuvant chemotherapy, and serosal invasion were independent risk factors for early recurrence (P<0.001, P=0.001, and P=0.010, respectively). A subgroup analysis showed patients with (n=51) and without (n=64) preoperative chemoradiotherapy had different predictors. Although postoperative adjuvant chemotherapy was not a significant indicator in patients with preoperative chemoradiotherapy, CA19-9 de-normalization and no postoperative adjuvant chemotherapy were significant indicators in patients without preoperative chemotherapy. Preoperative chemotherapy strongly prevented early local recurrence while postoperative adjuvant chemotherapy prevented early distant recurrence. Conclusions CA19-9 de-normalization was an important predictor of early recurrence of pancreatic ductal adenocarcinoma. Although postoperative adjuvant chemotherapy was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative chemoradiotherapy could strongly prevent the early local recurrence of pancreatic ductal adenocarcinoma. These perioperative adjuvant therapies could have a complementary relationship.

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The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy

10.21203/rs.2.11858/v2 ◽

2019 ◽

Author(s):

Hironobu Suto ◽

Keiichi Okano ◽

Minoru Oshima ◽

Yasuhisa Ando ◽

Shigeo Takahashi ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Local Recurrence ◽

Adjuvant Therapy ◽

Pancreatic Ductal Adenocarcinoma ◽

Preoperative Chemoradiotherapy ◽

Distant Recurrence ◽

Early Recurrence ◽

Ductal Adenocarcinoma ◽

Postoperative Adjuvant Chemotherapy ◽

Early Local Recurrence

Abstract Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma recurrence are unclear. This study attempted to identify the predictive factors for early pancreatic ductal adenocarcinoma recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy. Methods One hundred and fifteen patients undergoing curative resection for pancreatic ductal adenocarcinoma between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did (n=34) and did not (n=81) experience a recurrence within 6 months postoperatively. Results Multivariate analyses demonstrated postoperative CA19-9 de-normalization, no postoperative adjuvant chemotherapy, and serosal invasion were independent risk factors for early recurrence (P<0.001, P=0.001, and P=0.010, respectively). A subgroup analysis showed patients with (n=51) and without (n=64) preoperative chemoradiotherapy had different predictors. Although postoperative adjuvant chemotherapy was not a significant indicator in patients with preoperative chemoradiotherapy, CA19-9 de-normalization and no postoperative adjuvant chemotherapy were significant indicators in patients without preoperative chemotherapy. Preoperative chemotherapy strongly prevented early local recurrence while postoperative adjuvant chemotherapy prevented early distant recurrence. Conclusions CA19-9 de-normalization was an important predictor of early recurrence of pancreatic ductal adenocarcinoma. Although postoperative adjuvant chemotherapy was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative chemoradiotherapy could strongly prevent the early local recurrence of pancreatic ductal adenocarcinoma. These perioperative adjuvant therapies could have a complementary relationship.

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The predictors and patterns of the early recurrence of pancreatic ductal adenocarcinoma after pancreatectomy: the influence of pre- and post- operative adjuvant therapy

10.21203/rs.2.11858/v4 ◽

2019 ◽

Author(s):

Hironobu Suto ◽

Keiichi Okano ◽

Minoru Oshima ◽

Yasuhisa Ando ◽

Shigeo Takahashi ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Local Recurrence ◽

Adjuvant Therapy ◽

Pancreatic Ductal Adenocarcinoma ◽

Preoperative Chemoradiotherapy ◽

Distant Recurrence ◽

Early Recurrence ◽

Ductal Adenocarcinoma ◽

Postoperative Adjuvant Chemotherapy ◽

Early Local Recurrence

Abstract Background The perioperative factors predicting or influencing early pancreatic ductal adenocarcinoma recurrence are unclear. This study attempted to identify the predictive factors for early pancreatic ductal adenocarcinoma recurrence post-pancreatectomy and the influence of pre- and post- operative adjuvant therapy. Methods One hundred and fifteen patients undergoing curative resection for pancreatic ductal adenocarcinoma between 2000 and 2016 at our institution were retrospectively analyzed. Patients were divided into two groups: those who did (n=34) and did not (n=81) experience a recurrence within 6 months postoperatively. Results Multivariate analyses demonstrated postoperative CA19-9 de-normalization, no postoperative adjuvant chemotherapy, and serosal invasion were independent risk factors for early recurrence (P<0.001, P=0.001, and P=0.010, respectively). A subgroup analysis showed patients with (n=51) and without (n=64) preoperative chemoradiotherapy had different predictors. Although postoperative adjuvant chemotherapy was not a significant indicator in patients with preoperative chemoradiotherapy, CA19-9 de-normalization and no postoperative adjuvant chemotherapy were significant indicators in patients without preoperative chemotherapy. Preoperative chemotherapy strongly prevented early local recurrence while postoperative adjuvant chemotherapy prevented early distant recurrence. Conclusions CA19-9 de-normalization was an important predictor of early recurrence of pancreatic ductal adenocarcinoma. Although postoperative adjuvant chemotherapy was an important preventive measure against early recurrence, particularly for distant recurrence, preoperative chemoradiotherapy could strongly prevent the early local recurrence of pancreatic ductal adenocarcinoma. These perioperative adjuvant therapies could have a complementary relationship.

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Preoperative serum carbohydrate antigen 19-9 levels predict early recurrence after the resection of early-stage pancreatic ductal adenocarcinoma

Annals of Hepato-Biliary-Pancreatic Surgery ◽

10.14701/ahbps.bp-op-1-4 ◽

2021 ◽

Vol 25 (1) ◽

pp. S77-S77

Author(s):

Sarang HONG ◽

Ki Byung SONG ◽

Dae Wook HWANG ◽

Jae Hoon LEE ◽

Woohyung LEE ◽

...

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Early Stage ◽

Early Recurrence ◽

Carbohydrate Antigen ◽

Ductal Adenocarcinoma ◽

Preoperative Serum ◽

Serum Carbohydrate Antigen

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Pancreatic cancer stem cells may define tumor stroma characteristics and recurrence patterns in pancreatic ductal adenocarcinoma

BMC Cancer ◽

10.1186/s12885-021-08123-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gokce Askan ◽

Ibrahim Halil. Sahin ◽

Joanne F. Chou ◽

Aslihan Yavas ◽

Marinela Capanu ◽

...

Keyword(s):

Local Recurrence ◽

Pancreatic Ductal Adenocarcinoma ◽

Specific Antigen ◽

Tumor Stroma ◽

Distant Recurrence ◽

Ductal Adenocarcinoma ◽

Rank Test ◽

Stem Cell Markers ◽

Significant Difference ◽

The Impact

Abstract Background Herein, we investigate the relationship between pancreatic stem cell markers (PCSC markers), CD44, and epithelial-specific antigen (ESA), tumor stroma, and the impact on recurrence outcomes in pancreatic ductal adenocarcinoma (PDAC) patients. Methods PDAC patients who underwent surgical resection between 01/2012–06/2014 were identified. CD44 and ESA expression was assessed by immunohistochemistry. Stroma was classified as loose, moderate, and dense based on fibroblast content. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan-Meier method and compared between subgroups by log-rank test. The association between PCSC markers and stroma type was assessed by Fisher’s exact test. Results N = 93 PDAC patients were identified. The number of PDAC patients with dense, moderate density, and loose stroma was 11 (12%), 51 (54%), and 31 (33%) respectively. PDAC with CD44+/ESA− had highest rate of loose stroma (63%) followed by PDAC CD44+/ESA+ (50%), PDAC CD44−/ESA+ (35%), CD44−/ESA− (9%) (p = 0.0033). Conversely, lack of CD44 and ESA expression was associated with the highest rate of moderate and dense stroma (91% p = 0.0033). No local recurrence was observed in patients with dense stroma and 9 had distant recurrence. The highest rate of cumulative local recurrence was observed in patients with loose stroma. No statistically significant difference in RFS and OS was observed among subgroups (P = 0.089). Conclusions These data indicate PCSCs may have an important role in stroma differentiation in PDAC. Our results further suggest that tumor stroma may influence the recurrence pattern in PDAC patients.

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