■这项研究确定了手术前腹部MRI对切除PDAC患者全因死亡率的影响。
■2011年1月至2022年12月在安大略省接受胰腺切除术的所有成人(≥18岁)PDAC患者,加拿大,为这项基于人群的队列研究确定(ICD-O-3代码:C250,C251,C252,C253,C257,C258)。患者人口统计学,合并症,PDAC级,医疗和外科管理,生存数据来自ICES多个链接的省级行政数据库。在控制多个协变量后,比较了有和没有手术前腹部MRI的患者的全因死亡率。
■4579名患者的队列包括2432名男性(53.1%)和2147名女性(46.9%),平均年龄为65.2岁(标准差:11.2岁);2998人(65.5%)死亡,1581人(34.5%)存活。切除术后的中位随访时间为22.4个月(四分位距:10.8-48.8个月),胰腺切除术后中位生存期为25.9个月(95%置信区间[95%CI]:24.8,27.5).接受术前腹部MRI检查的患者的中位生存期为33.1个月(95%CI:30.7,37.2),而其他所有患者的中位生存期为21.1个月(95%CI:19.8,22.6)。共有2354/4579(51.4%)患者接受了术前腹部MRI检查,这与全因死亡率下降17.2%(95%CI:11.0,23.1)有关,调整后的风险比(aHR)为0.828(95%CI:0.769,0.890)。
术前腹部MRI与接受胰腺切除术的PDAC患者的总生存率提高相关,可能是由于肝转移比CT更好的检测。
■北安大略省学术医学协会(NOAMA)临床创新基金。
UNASSIGNED: This study determined the impact of pre-operative abdominal MRI on all-cause mortality for patients with resected PDAC.
UNASSIGNED: All adult (≥18 years) PDAC patients who underwent
pancreatectomy between January 2011 and December 2022 in Ontario, Canada, were identified for this population-based cohort study (ICD-O-3 codes: C250, C251, C252, C253, C257, C258). Patient demographics, comorbidities, PDAC stage, medical and surgical management, and survival data were sourced from multiple linked provincial administrative databases at ICES. All-cause mortality was compared between patients with and without a pre-operative abdominal MRI after controlling for multiple covariates.
UNASSIGNED: A cohort of 4579 patients consisted of 2432 men (53.1%) and 2147 women (46.9%) with a mean age of 65.2 years (standard deviation: 11.2 years); 2998 (65.5%) died while 1581 (34.5%) survived. Median follow-up duration post-resection was 22.4 months (interquartile range: 10.8-48.8 months), and median survival post-
pancreatectomy was 25.9 months (95% confidence interval [95% CI]: 24.8, 27.5). Patients who underwent a pre-operative abdominal MRI had a median survival of 33.1 months (95% CI: 30.7, 37.2) compared to 21.1 months (95% CI: 19.8, 22.6) for all others. A total of 2354/4579 (51.4%) patients underwent a pre-operative abdominal MRI, which was associated with a 17.2% (95% CI: 11.0, 23.1) decrease in the rate of all-cause mortality, with an adjusted hazard ratio (aHR) of 0.828 (95% CI: 0.769, 0.890).
UNASSIGNED: Pre-operative abdominal MRI was associated with improved overall survival for PDAC patients who underwent
pancreatectomy, possibly due to better detection of liver metastases than CT.
UNASSIGNED: Northern Ontario Academic Medicine Association (NOAMA) Clinical Innovation Fund.