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- 저자 : Dayem Ullah (검색결과 1 건)
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Andrew Ang,Athena Michaelides,Claude Chelala,Dayem Ullah,Hemant M. Kocher 한국간담췌외과학회 2024 Annals of hepato-biliary-pancreatic surgery Vol.28 No.2
Backgrounds/Aims: This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC). Methods: Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model. Results: Of 91 people (42 males [46%]; median age, 71 years [range, 43–86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40–61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6–10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2–7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7–15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6–10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4–14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4–5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2–0.7). Conclusions: Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.
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