Original CommunicationA new preoperative prognostic scoring system to predict prognosis in patients with locally advanced pancreatic body cancer who undergo distal pancreatectomy with en bloc celiac axis resection: A retrospective cohort study
Section snippets
Indications for DP-CAR and the operative procedure
The indication for DP-CAR was locally advanced ductal adenocarcinoma of the body of the pancreas, such as that which involved or touched the common hepatic artery, the root of the splenic artery, and/or the celiac axis, without distant metastasis. The gastroduodenal artery and the superior mesenteric artery had to be preserved. Tumor progression was usually evaluated with preoperative imaging modalities, including computed tomography (CT), magnetic resonance imaging, and endoscopic
Methods
Various clinical and clinicopathologic data from 50 consecutive patients with pancreatic body cancer who underwent DP-CAR were collected retrospectively and analyzed comprehensively to identify prognostic factors. These factors, which were extracted from the database for analysis, were divided into 3 categories: Patient factors (gender, age, body weight, body mass index, smoking history, drinking history, underlying disease, diabetic mellitus, cancer pain, preoperative platelet counts,
Postoperative survival
The estimated disease-specific 1-, 3-, and 5-year survival rates for the 50 patients were 80.7%, 32.3%, and 24.3%, respectively, and the median survival time was 24.7 months (Fig 1). Estimated disease-specific 1-, 3-, and 5-year survival rates for the 15 patients with UICC stage IIA disease were 85.7%, 55.1%, and 36.7%, respectively, and for the 18 patients with UICC stage IIB disease, they were 81.9%, 25.5%, and not available, respectively. The median survival times for stage IIA and IIB
Discussion
Based on comprehensive analyses of preoperative patient factors, treatment-related factors, and tumor factors in the present study, 4 independent adverse prognostic factors (intraoperative blood loss, preoperative platelet counts, preoperative CRP levels, and preoperative CA19-9 levels) were identified that impacted survival after resection of locally advanced pancreatic body cancer in patients who underwent DP-CAR. Using the preoperative prognostic scoring system that included preoperative
References (43)
- et al.
Stomach-preserving distal pancreatectomy with combined resection of the celiac artery: radical procedure for locally advanced cancer of the pancreatic body
J Gastrointest Surg
(2007) - et al.
Analysis of long-term survivors after surgical resection for invasive pancreatic cancer
HPB
(2005) - et al.
Prognostic factors after distal pancreatectomy with extended lymphadenectomy for invasive pancreatic adenocarcinoma of the body and tail
Surgery
(2006) - et al.
Increased preoperative platelet count is associated with decreased survival after resection for adenocarcinoma of the pancreas
Am J Surg
(2005) Platelet counts and prognosis of pancreatic cancer
Lancet
(1999)- et al.
Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma
Am J Surg
(2009) - et al.
Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio
Am J Surg
(2010) - et al.
Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer
Pancreatology
(2006) - et al.
Evaluation of an inflammation-based prognostic score in patients with advanced ovarian cancer
Eur J Cancer
(2008) - et al.
An aggressive therapeutic approach to carcinoma of the body and tail of the pancreas
Cancer
(1996)
Distal pancreatectomy with en bloc resection of the celiac artery for carcinoma of the body and tail of the pancreas
Int J Pancreatol
Results of radical distal pancreatectomy with en bloc resection of the celiac artery for locally advanced cancer of the pancreatic body
Langenbecks Arch Surg
Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results
Ann Surg
The coeliac axis in the expansion of the operation for gastric carcinoma
Cancer
Radical distal pancreatectomy with en bloc resection of the celiac artery, plexus, and ganglions for advanced cancer of the pancreatic body: a preliminary report on perfect pain relief
JOP
Postoperative bowel function and nutritional status following distal pancreatectomy with en-bloc celiac axis resection
Dig Surg
Preoperative embolization of the common hepatic artery in preparation for radical pancreatectomy for pancreas body cancer
Hepatogastroenterology
Ischemic gastropathy after distal pancreatectomy with celiac axis resection
Surg Today
TNM classification of malignant tumors
Role of systemic inflammatory response in predicting survival in patients with primary operable cancer
Future Oncol
Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small cell lung cancer
Br J Cancer
Cited by (46)
Modified Appleby procedure for locally advanced pancreatic carcinoma: A primer for the radiologist
2023, Diagnostic and Interventional ImagingSelecting chemotherapy for pancreatic cancer: Far away or so close?
2019, Seminars in OncologyPreoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection
2018, Hepatobiliary and Pancreatic Diseases InternationalCitation Excerpt :Only one report [16] suggested an association with ER with elevated mGPS in PDAC patients. Preoperative CRP level was a significant prognosticator with preoperative platelet count and CA19-9 level (incorporated into preoperative prognostic score) to predict overall survival in locally advanced pancreatic body cancer patients who underwent distal pancreatectomy [34]. In this study, significant decrease in total lymphocyte count > 50% of baseline value in the preoperative period was also an independent risk factor for the occurrence of ER in R-PDAC patients after surgery.
Extended Radical Surgery for Pancreatic Cancer
2023, The Pancreas: an Integrated Textbook of Basic Science, Medicine, and Surgery, Fourth Edition