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01-02-2011 | Gastrointestinal Oncology

Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines

Authors: Fuyuhiko Motoi, MD, PhD, Toshiki Rikiyama, MD, PhD, Yu Katayose, MD, PhD, Shin-ichi Egawa, MD, PhD, Michiaki Unno, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2011

Abstract

Purpose

The purpose of this study was to obtain a comprehensive understanding of the impact of postoperative tumor marker (TM) normalization on survival after pancreatectomy for pancreatic carcinoma. We propose the concept of surgical RECIST based on residual tumor and TM status.

Methods

A total of consecutive patients with pancreatic carcinoma underwent pancreatectomy between August 1, 1989, and August 1, 2008. Pre- and postoperative TM values were available for 194 patients. The relationship between TM status, survival, and other clinical and demographic data was determined with univariate log-rank tests and Cox proportional hazards analysis.

Results

Postoperative TM levels remained elevated in 92 patients (47.4%; partial responders). TM levels normalized in 102 patients (52.6%; complete responders). Lymph node metastases, portal vein resection, absence of retroperitoneal clearance, residual tumor, preoperative high CA19-9, and surgical partial response were associated with decreased survival. Nodal stage (P = 0.0227) and surgical RECIST (P = 0.025) were significant predictors of survival. Partial responders had a significantly lower median survival time (P = 0.0008) and significantly higher frequency of hepatic metastasis (P = 0.0299).

Conclusions

Postresection TM normalization is a strong prognostic factor for pancreatic cancer. The efficacy of pancreatic cancer surgery should be evaluated in the context of both local clearance and serum TM kinetics.

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Title: Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines
Authors: Fuyuhiko Motoi, MD, PhD
Toshiki Rikiyama, MD, PhD
Yu Katayose, MD, PhD
Shin-ichi Egawa, MD, PhD
Michiaki Unno, MD, PhD
Publication date: 01-02-2011
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 2/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-1311-x

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Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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