PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC).
UNASSIGNED: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model.
UNASSIGNED: Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7).
UNASSIGNED: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.
UNASSIGNED: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model.
UNASSIGNED: Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7).
UNASSIGNED: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.
摘要：
■本研究旨在探讨胰腺导管腺癌（PDAC）根治性切除术后复发的模式和影响因素。
■连续接受PDAC治疗（2011-21）并同意数据和组织收集（Barts胰腺组织库）的患者随访至2023年5月。使用Cox比例风险模型分析临床病理变量。
■91人（42名男性[46%]；中位年龄，71年[范围，43-86岁])，中位随访时间为51个月(95%置信区间[CI]，40-61个月），复发率为72.5%(n=66；12个局部区域，11只肝脏，5单肺，3单独腹膜，29同时发生局部区域和远处转移，和6个首次复发诊断时的多灶性远处转移）。中位复发时间为8.5个月（95%CI，6.6-10.5个月）。复发后中位生存期为5.8个月（95%CI，4.2-7.3个月）。按复发位置进行分层显示，仅在局部区域复发之间的复发时间存在显着差异（中位数，13.6个月；95%CI，11.7-15.5个月）和同时发生局部区域并伴有远处复发（中位数，7.5个月；95％CI，4.6-10.4个月；p=0.02，成对对数秩检验）。复发的重要预测因素是全身炎症指数（SII）≥500（风险比[HR]，4.5；95%CI，1.4-14.3），淋巴结比率≥0.33(HR，2.8；95%CI，1.4-5.8），和辅助化疗（HR，0.4；95%CI，0.2-0.7）。
■仅局部复发的时间明显长于同时局部复发和远处复发的时间。复发的重要预测因素是SII，淋巴结定量，和辅助化疗。
■连续接受PDAC治疗（2011-21）并同意数据和组织收集（Barts胰腺组织库）的患者随访至2023年5月。使用Cox比例风险模型分析临床病理变量。
■91人（42名男性[46%]；中位年龄，71年[范围，43-86岁])，中位随访时间为51个月(95%置信区间[CI]，40-61个月），复发率为72.5%(n=66；12个局部区域，11只肝脏，5单肺，3单独腹膜，29同时发生局部区域和远处转移，和6个首次复发诊断时的多灶性远处转移）。中位复发时间为8.5个月（95%CI，6.6-10.5个月）。复发后中位生存期为5.8个月（95%CI，4.2-7.3个月）。按复发位置进行分层显示，仅在局部区域复发之间的复发时间存在显着差异（中位数，13.6个月；95%CI，11.7-15.5个月）和同时发生局部区域并伴有远处复发（中位数，7.5个月；95％CI，4.6-10.4个月；p=0.02，成对对数秩检验）。复发的重要预测因素是全身炎症指数（SII）≥500（风险比[HR]，4.5；95%CI，1.4-14.3），淋巴结比率≥0.33(HR，2.8；95%CI，1.4-5.8），和辅助化疗（HR，0.4；95%CI，0.2-0.7）。
■仅局部复发的时间明显长于同时局部复发和远处复发的时间。复发的重要预测因素是SII，淋巴结定量，和辅助化疗。
