|
Back to 2017 Posters
RISK FACTORS OF 12-MONTH RECURRENCE IN PATIENTS WITH PANCREATIC DUCTAL ADENOCARCINOMA UNDERGOING PANCREATODUODENECTOMY
Jorge Hernandez Calleros, Hiram Tadeo Espinoza*, Luis Uscanga, Mario Pelaez-Luna
Gastroenterology, Instituto Nacional de Ciencias Medicas y Nutricion, Mexico, Mexico
Background
Pancreatic ductal adenocarcinoma is the fourth most common cause of cancer death in United States. Pancreatoduodenectomy is the only potentially curative treatment, but due to the presentation in advanced stages only 15 - 20 % is amenable. Despite the curative intent of surgical resection, cancer recurrence develops within two years after pancreatic surgery in over 60% of patients.
The aim of the present study was to evaluate risk factors of 12-month recurrence after surgical resection with curative intent in pancreatic ductal adenocarcinoma patients.
Material and methods
All patients with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy at a single institution during the period 2010-2015 were enrolled for their retrospective study. The clinical stage was classified according to the criteria of the American Joint Committee on Cancer.
Demographic, clinical, histopathological baseline characteristics and also disease-free survival (months) were noted.
Comparisons between variables were analyzed with chi square and logistic regression analysis, statistical inferences were evaluated with a significance level of 5%.
Results
49 patients with pancreatic ductal adenocarcinoma were studied, 22 (45%) were men and 27 (55%) were women. The median (95% IC) age was 65 (59 - 69) years, recurrence was observed in 28 (57.1%) patients; the median (95% IC) disease-free survival was 10 (6 - 13) months. In univariate analysis; clinical stage IIB, moderate and poor differentiated tumors were associated with 12-month recurrence (P = 0.002, 0.003, 0.001 respectively). These factors in a prediction model were statistically significant for recurrence (p = 0.001). On the other hand, in the multivariate analysis, in our study only clinical stage showed to be an independent prognostic factor of recurrence after surgical resection with curative intent (IC 95% 1.4 - 35.0 HR= 2.94 p = 0.019).
Conclusion
More than half of patients who undergo pancreatoduodenectomy for pancreatic ductal adenocarcinoma develop recurrence at 12 months.
The combination of factors such as: clinical stage (IIB) and differentiation degree (moderate and undifferentiated) could be useful as 12-month recurrence predictors.
Futher research is necessary to identify more prognostic factors for recurrence after pancreatoduodenectomy and improve disease-free survival in patients with potentially resectable pancreatic adenocarcinoma.
Back to 2017 Posters
|
