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Lookup NU author(s): Dr Beate Haugk, Steven White, Professor Sanjay PandanaboyanaORCiD
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© 2024 Elsevier Inc.Background: Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasms are unknown. This study determines predictors of long-term (>5 years) disease-free survival and recurrence in adenocarcinoma arising from intraductal papillary mucinous neoplasms and derives a prognostic model for disease-free survival. Methods: Consecutive patients who underwent pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms in 18 academic pancreatic centers in Europe and Asia between 2010 to 2017 with at least 5-year follow-up were identified. Factors associated with disease-free survival were determined using Cox proportional hazards model. Internal validation was performed, and discrimination and calibration indices were assessed. Results: In the study, 288 patients (median age, 70 years; 52% male) were identified; 140 (48%) patients developed recurrence after a median follow-up of 98 months (interquartile range, 78.4–123), 57 patients (19.8%) developed locoregional recurrence, and 109 patients (37.8%) systemic recurrence. At 5 years after resection, the overall and disease-free survival was 46.5% (134/288) and 35.0% (101/288), respectively. On Cox proportional hazards model analysis, multivisceral resection (hazard ratio, 2.20; 95% confidence interval, 1.06–4.60), pancreatic tail location (hazard ratio, 2.34; 95% confidence interval, 1.22–4.50), poor tumor differentiation (hazard ratio, 2.48; 95% confidence interval, 1.10–5.30), lymphovascular invasion (hazard ratio, 1.74; 95% confidence interval, 1.06–2.88), and perineural invasion (hazard ratio, 1.83; 95% confidence interval, 1.09–3.10) were negatively associated with long-term disease-free survival. The final predictive model incorporated 8 predictors and demonstrated good predictive ability for disease-free survival (C-index, 0.74; calibration, slope 1.00). Conclusion: A third of patients achieve long-term disease-free survival (>5 years) after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms. The predictive model developed in the current study can be used to estimate the probability of long-term disease-free survival.
Author(s): Lucocq J, Joseph N, Hawkyard J, Haugk B, White S, Lye J, Parkinson D, Mownah O, Menon K, Furukawa T, Hirose Y, Sasahira N, Inoue Y, Mittal A, Samra J, Sheen A, Feretis M, Balakrishnan A, Ceresa C, Davidson B, Pande R, Dasari B, Roberts K, Tanno L, Karavias D, Helliwell J, Young A, Marks K, Nunes Q, Urbonas T, Silva M, Gordon-Weeks A, Barrie J, Gomez D, van Laarhoven S, Nawara H, Doyle J, Bhogal R, Harrison E, Roalso M, Ciprani D, Aroori S, Ratnayake B, Koea J, Capurso G, Stattner S, Bellotti R, Alsaoudi T, Bhardwaj N, Rajesh S, Jeffery F, Connor S, Cameron A, Jamieson N, Gill A, Soreide K, Pandanaboyana S
Publication type: Article
Publication status: Published
Journal: Surgery
Year: 2024
Pages: epub ahead of print
Online publication date: 25/06/2024
Acceptance date: 06/05/2024
ISSN (print): 0039-6060
ISSN (electronic): 1532-7361
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.surg.2024.05.010
DOI: 10.1016/j.surg.2024.05.010
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