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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgement

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.”

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea

    Sung Hwan Lee, Ho Kyoung Hwang, Chang Moo Kang & Woo Jung Lee

  2. Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea

    Sung Hwan Lee, Ho Kyoung Hwang, Chang Moo Kang & Woo Jung Lee

Authors
  1. Sung Hwan Lee
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  2. Ho Kyoung Hwang
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  3. Chang Moo Kang
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Corresponding author

Correspondence to Chang Moo Kang.

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Disclosures

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

Electronic supplementary material

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Supplementary Fig. 1

Distributions of propensity score before and after matching. (TIFF 902 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)

Supplementary material 3 (DOCX 17 kb)

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Lee, S.H., Hwang, H.K., Kang, C.M. et al. The Yonsei criteria as a clinically detectable parameter for excellent prognosis in resected left-sided pancreatic cancer: outcomes of a propensity score-matched analysis. Surg Endosc 31, 4656–4664 (2017). https://doi.org/10.1007/s00464-017-5529-6

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  • DOI: https://doi.org/10.1007/s00464-017-5529-6

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