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Prognostic factors for actual long-term survival in the era of multidisciplinary treatment for pancreatic ductal adenocarcinoma

Abstract

Purpose

Recent advances in multidisciplinary treatments are improving the postoperative prognosis of pancreatic ductal adenocarcinoma (PDAC). However, the prognosis even after potentially curative resection remains poor. The aim of this study was to identify the clinical and pathological features of actual 5-year survivors under current circumstances.

Methods

A total of 128 patients who underwent pancreatectomy for PDAC at our institution between January 2006 and December 2011 were retrospectively analyzed.

Results

The actual 5-year overall survival rate for all patients was 30.9%, with a median survival time of 33.1 months. Of 128 patients, 25 (19.5%) survived for 5 years after surgery without disease recurrence. A univariate analysis showed that the pretreatment serum CA19–9 value, tumor depth, lymph node metastasis, and UICC stage at resection were significant predictive factors for the actual long-term survival. A multivariate analysis showed that a pretreatment serum CA19–9 value ≥ 110 U/mL was a significant unfavorable prognostic indicator. In addition, all subjects in the 5-year survival group completed adjuvant chemotherapy. The recurrence rate in the liver was significantly lower and that in the lung significantly higher in the long-term survival group than in the short-term survival group.

Conclusions

The factors contributing to the long-term survival of PDAC were the pretreatment CA19–9 value and the completion of adjuvant chemotherapy. To achieve the actual long-term survival and cure after pancreatectomy for pancreatic cancer, further treatment strategies enhancing the completion rate of adjuvant chemotherapy are required.

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Authors

Contributions

Study conception and design: Kenji Nakagawa and Masayuki Sho; acquisition of data: all authors; analysis and interpretation of data: all authors; drafting the manuscript: Kenji Nakagawa and Masayuki Sho; critical revision of the manuscript: all authors.

Corresponding author

Correspondence to Masayuki Sho.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was conducted with the approval of the Nara Medical University Hospital Institutional Review Board (No.1557).

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

Nakagawa, K., Akahori, T., Nishiwada, S. et al. Prognostic factors for actual long-term survival in the era of multidisciplinary treatment for pancreatic ductal adenocarcinoma. Langenbecks Arch Surg 403, 693–700 (2018). https://doi.org/10.1007/s00423-018-1709-7

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Keywords

  • Pancreatic cancer
  • Multidisciplinary treatment
  • Actual long-term survival
  • Prognostic factor