1. Prediction of residual tumor and overall survival after first-line surgery in patients with pancreatic ductal adenocarcinoma using preoperative magnetic resonance imaging findings.
- Author
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Bae JS, Kim JH, Kang HJ, and Han JK
- Subjects
- Adenocarcinoma mortality, Carcinoma, Pancreatic Ductal mortality, Female, Humans, Male, Middle Aged, Neoplasm, Residual, Pancreas diagnostic imaging, Pancreas surgery, Pancreatic Neoplasms mortality, Predictive Value of Tests, Preoperative Care methods, Retrospective Studies, Survival Analysis, Adenocarcinoma diagnostic imaging, Adenocarcinoma surgery, Carcinoma, Pancreatic Ductal diagnostic imaging, Carcinoma, Pancreatic Ductal surgery, Magnetic Resonance Imaging methods, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms surgery
- Abstract
Background: Complete resection is the only potentially curative treatment in patients with pancreatic ductal adenocarcinoma (PDA) and is associated with a longer overall survival (OS) than incomplete resection of tumor. Hence, prediction of the resection status after surgery would help predict the prognosis of patients with PDA., Purpose: To predict residual tumor (R) classification and OS in patients who underwent first-line surgery for PDA using preoperative magnetic resonance imaging (MRI)., Material and Methods: In this study, 210 patients with PDA who underwent MRI and first-line surgery were randomly categorized into a test group (n=150) and a validation group (n=60). The R classification was divided into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). Preoperative MRI findings associated with R classification and OS were assessed by using logistic regression and Cox proportional hazard models. In addition, the prediction models for the R classification and OS were validated using calibration plots and C statistics., Results: On preoperative MRI, portal vein encasement (odds ratio 4.755) was an independent predictor for R1/R2 resection ( P =0.040). Tumor size measured on MRI (hazard ratio [HR] per centimeter 1.539) was a predictor of OS, along with pathologic N1 and N2 stage (HR 1.944 and 3.243, respectively), R1/R2 resection (HR 3.273), and adjuvant chemoradiation therapy (HR 0.250) ( P <0.050). Calibration plots demonstrated satisfactory predictive performance., Conclusion: Preoperative MRI was valuable for predicting R1/R2 resection using portal vein encasement. Tumor size measured on MRI was useful for the prediction of OS after first-line surgery for PDA.
- Published
- 2022
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