Surgical Endoscopy

, Volume 31, Issue 11, pp 4656–4664 | Cite as

The Yonsei criteria as a clinically detectable parameter for excellent prognosis in resected left-sided pancreatic cancer: outcomes of a propensity score-matched analysis

  • Sung Hwan Lee
  • Ho Kyoung Hwang
  • Chang Moo KangEmail author
  • Woo Jung Lee



This study aimed to identify that Yonsei criteria (YC) can be regarded as a preoperative clinical parameter to predict biological behavior of the left-sided pancreatic cancer.


Between June 2007 and December 2014, 135 patients who underwent minimally invasive (MIS) or open distal pancreatectomy for left-sided pancreatic cancer were enrolled in this study consecutively. Perioperative short-term and long-term oncologic outcomes were analyzed according to the YC retrospectively.


Fifty-four and 81 patients did and did not meet the YC, respectively. Short-term oncologic outcomes were favorable among those meeting the YC even after propensity score matching. Patients within the YC also had better disease-free and disease-specific overall survival (p < 0.05). In analysis for receiver operating characteristic curve, area under curve of CA19-9 was satisfactory only within YC group. Multivariate analysis for disease-free survival identified the YC as a strong independent prognostic factor (p < 0.05). In preoperative clinical setting, patients’ survival was clearly different based on following clinical groups, such as within YC, beyond YC, and unresectable.


Preoperative CT-based determined YC can predict excellent short-term and long-term oncologic outcomes. YC might have a potential role as a preoperative clinical staging for left-sided pancreatic cancer. External validations of YC based on multicenter cohorts are mandatory to confirm this oncologic significance of YC.


Pancreatic cancer Disease-free survival Selection criteria 



Parts of this manuscript were presented in the Hepatobiliary Oncology Session at the GAP 2015 Conference, April 14–15, 2016, at the MD Anderson Cancer Center, Houston, TX, USA under the title “Yonsei Criteria in Minimally Invasive Surgery for Left-sided Pancreatic Cancer.”

Compliance with ethical standards


Drs. Sung Hwan Lee, Ho Kyoung Hwang, Chang Moo Kang and Woo Jung Lee have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5529_MOESM1_ESM.tif (902 kb)
Supplementary Fig. 1 Distributions of propensity score before and after matching. (TIFF 902 kb)
464_2017_5529_MOESM2_ESM.tif (578 kb)
Supplementary Fig. 2 Survival analysis for detailed population. Kaplan–Meier plots show disease-free survivals for pathologic T3 group (a) and practically detectable early pancreatic cancer in terms of node negative and well differentiated histology, and within YC (b). (TIFF 578 kb)
464_2017_5529_MOESM3_ESM.docx (18 kb)
Supplementary material 3 (DOCX 17 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Division of Hepatobiliary and Pancreatic Surgery, Department of SurgeryYonsei University College of MedicineSeoulKorea
  2. 2.Pancreatobiliary Cancer Clinic, Yonsei Cancer CenterSeverance HospitalSeoulKorea

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