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Prognostic factor in patient with recurrent pancreatic adenocarcinoma

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Abstract

Purpose

To elucidate prognostic factors for post-recurrence survival in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

Patients who underwent curative-intent surgery for PDAC between January 2014 and May 2020 were identified. Among them, patients who had postoperative recurrences and received chemotherapy were retrospectively investigated. Independent prognostic factors for survival after recurrence were investigated using multivariate analyses. Eligible patients were divided into two groups according to the presence or absence of the identified prognostic factors, and survival times after recurrence were compared.

Results

Eighty-four patients with recurrent PDAC were included. Multivariate analysis showed that red blood cell (RBC) transfusion (HR, 2.80; p = 0.0051), low albumin level (HR, 1.84; p = 0.0402), and high carbohydrate antigen 19-9 (CA19-9) level at recurrence (HR, 2.11; p = 0.0258) were significant predictors of shorter survival after recurrence. The median survival times after recurrence in the transfusion and non-transfusion groups were 5.5 vs. 18.1 months (p < 0.0001), respectively; those in the low and normal albumin groups were 10.1 vs. 18.7 months (p = 0.0049), and those in the high and normal CA19-9 groups were 11.5 vs. 22.6 months (p = 0.0023), respectively.

Conclusions

RBC transfusion, low albumin, and high CA19-9 levels at recurrence negatively affected survival after recurrence in patients with PDAC.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan

    Tatsuaki Sumiyoshi, Kenichiro Uemura, Ryuta Shintakuya, Kenjiro Okada, Hiroyuki Otsuka, Kenta Baba & Shinya Takahashi

  2. Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan

    Masahiro Serikawa, Yasutaka Ishii & Tomofumi Tsuboi

  3. Department of Anatomical Pathology, Hiroshima University, Hiroshima, Japan

    Koji Arihiro

  4. Digestive Disease Center, Hiroshima Memorial Hospital, Hiroshima, Japan

    Yoshiaki Murakami

  5. Department of Surgery, Saijyo Central Hospital, Saijo, Japan

    Jyunji Murashita

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  1. Tatsuaki Sumiyoshi
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  2. Kenichiro Uemura
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Contributions

TS, KU, RS, KO, and HO wrote the manuscript. TS and KB collected the data. KA engaged in the pathological assessment. MS, YI, TT, YM JM, and ST edited the manuscript. All authors reviewed the manuscript.

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Correspondence to Kenichiro Uemura.

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Sumiyoshi, T., Uemura, K., Shintakuya, R. et al. Prognostic factor in patient with recurrent pancreatic adenocarcinoma. Langenbecks Arch Surg 408, 347 (2023). https://doi.org/10.1007/s00423-023-03073-2

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