Search: onr:"swepub:oai:DiVA.org:umu-225508" >
Radiologic occult m...
Radiologic occult metastases in pancreatic cancer : analysis of risk factors and survival outcomes in the age of contemporary neoadjuvant multi-agent chemotherapy
-
- Yee, Elliott J. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Torphy, Robert J. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Thielen, Otto N. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
show more...
-
- Easwaran, Lavanya (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Franklin, Oskar, 1985- (author)
- Umeå universitet,Kirurgi,Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Sugawara, Toshitaka (author)
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
-
- Bartsch, Christan (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Garduno, Nicole (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- McCarter, Martin M. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Ahrendt, Steven A. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Schulick, Richard D. (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
- Del Chiaro, Marco (author)
- Department of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, CO, Aurora, United States
-
show less...
-
(creator_code:org_t)
- 2024
- 2024
- English.
-
In: Annals of Surgical Oncology. - : Springer Nature. - 1068-9265 .- 1534-4681.
- Related links:
-
https://urn.kb.se/re...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Background: Radiologic occult metastatic disease (ROMD) in patients with pancreatic ductal adenocarcinoma (PDAC) who undergo contemporary neoadjuvant chemotherapy (NAC) has not been well studied. This study sought to analyze the incidence, risk factors, and oncologic outcomes for patients who underwent the NAC approach for PDAC.Methods: A retrospective review analyzed a prospectively maintained database of patients who had potentially resectable PDAC treated with NAC and were offered pancreatectomy at our institution from 2011 to 2022. Multivariable regression analysis was performed to assess risk factors associated with ROMD. Kaplan-Meier curves with log-rank analyses were generated to estimate time-to-event end points.Results: The study enrolled 366 patients. Upfront and borderline resectable anatomic staging comprised 80% of the cohort, whereas 20% had locally advanced disease. The most common NAC regimen was FOLFIRINOX (n = 274, 75%). For 55 patients (15%) who harbored ROMD, the most common site was liver-only metastases (n = 33, 60%). The independent risk factors for ROMD were increasing CA19-9 levels during NAC (odds ratio [OR], 7.01; confidence interval [CI], 1.97–24.96; p = 0.008), indeterminate liver lesions (OR, 2.19; CI, 1.09-4.39; p = 0.028), and enlarged para-aortic lymph nodes (OR, 6.87; CI, 2.07–22.74; p = 0.002) on preoperative cross-sectional imaging. Receipt of palliative chemotherapy (p < 0.001) and eventual formal pancreatectomy (p = 0.04) were associated with survival benefit in the log-rank analysis. The median overall survival (OS) of the patients with ROMD was nearly 15 months from the initial diagnosis, with radiologic evidence of metastases occurring after a median of 2 months.Conclusions: Radiologic occult metastatic disease remains a clinical challenge associated with poor outcomes for patients who have PDAC treated with multi-agent NAC.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Yee, Elliott J.
-
Torphy, Robert J ...
-
Thielen, Otto N.
-
Easwaran, Lavany ...
-
Franklin, Oskar, ...
-
Sugawara, Toshit ...
-
show more...
-
Bartsch, Christa ...
-
Garduno, Nicole
-
McCarter, Martin ...
-
Ahrendt, Steven ...
-
Schulick, Richar ...
-
Del Chiaro, Marc ...
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Cancer and Oncol ...
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Surgery
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Gastroenterology ...
- Articles in the publication
-
Annals of Surgic ...
- By the university
-
Umeå University