Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma

Lois A Daamen; Galina Dorland; Lilly J H Brada; Vincent P Groot; A Floortje van Oosten; Marc G Besselink; Koop Bosscha; Bert A Bonsing; Olivier R Busch; Geert A Cirkel; Ronald M van Dam; Sebastiaan Festen; Bas Groot Koerkamp; Nadia Haj Mohammad; Erwin van der Harst; Ignace H J T de Hingh; Martijn P W Intven; Geert Kazemier; Maartje Los; Vincent E de Meijer; Vincent B Nieuwenhuijs; Daphne Roos; Jennifer M J Schreinemakers; Martijn W J Stommel; Robert C Verdonk; Helena M Verkooijen; I Quintus Molenaar; Hjalmar C van Santvoort; Dutch Pancreatic Cancer Group

doi:10.1016/j.hpb.2021.09.004

Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma

Lois A Daamen^*, Galina Dorland, Lilly J H Brada, Vincent P Groot, A Floortje van Oosten, Marc G Besselink, Koop Bosscha, Bert A Bonsing, Olivier R Busch, Geert A Cirkel, Ronald M van Dam, Sebastiaan Festen, Bas Groot Koerkamp, Nadia Haj Mohammad, Erwin van der Harst, Ignace H J T de Hingh, Martijn P W Intven, Geert Kazemier, Maartje Los, Vincent E de MeijerVincent B Nieuwenhuijs, Daphne Roos, Jennifer M J Schreinemakers, Martijn W J Stommel, Robert C Verdonk, Helena M Verkooijen, I Quintus Molenaar, Hjalmar C van Santvoort^*, Dutch Pancreatic Cancer Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy.

METHODS: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection.

RESULTS: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) <3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence <3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90° venous involvement on CT imaging (OR 2.93 [95% CI 1.60-5.37]; P < 0.001) were associated with recurrence within 3-6 months. A Charlson Age Comorbidity Index ≥4 (OR 1.53 [95% CI 1.09-2.16]; P = 0.02) and logCA 19-9 (OR 1.24 [95% CI 1.14-1.35]; P < 0.001) were related to recurrence within 6-12 months.

CONCLUSION: This study demonstrates preoperative predictors that are associated with the manifestation of early and very early recurrence after PDAC resection. Knowledge of these predictors can be used to guide individualized surveillance and treatment strategies.

Original language	English
Pages (from-to)	535-546
Number of pages	12
Journal	HPB
Volume	24
Issue number	4
Early online date	24 Sept 2021
DOIs	https://doi.org/10.1016/j.hpb.2021.09.004
Publication status	Published - Apr 2022

Keywords

SURVIVAL
THERAPY
UPFRONT SURGERY
ADJUVANT CHEMOTHERAPY
QUALITY-OF-LIFE
GEMCITABINE

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Daamen, L. A., Dorland, G., Brada, L. J. H., Groot, V. P., van Oosten, A. F., Besselink, M. G., Bosscha, K., Bonsing, B. A., Busch, O. R., Cirkel, G. A., van Dam, R. M., Festen, S., Groot Koerkamp, B., Haj Mohammad, N., van der Harst, E., de Hingh, I. H. J. T., Intven, M. P. W., Kazemier, G., Los, M., ... Dutch Pancreatic Cancer Group (2022). Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma. HPB, 24(4), 535-546. https://doi.org/10.1016/j.hpb.2021.09.004

@article{3acd987b1a794d2ba0d0a964cb19907e,

title = "Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma",

abstract = "BACKGROUND: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy.METHODS: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection.RESULTS: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) <3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence <3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90° venous involvement on CT imaging (OR 2.93 [95% CI 1.60-5.37]; P < 0.001) were associated with recurrence within 3-6 months. A Charlson Age Comorbidity Index ≥4 (OR 1.53 [95% CI 1.09-2.16]; P = 0.02) and logCA 19-9 (OR 1.24 [95% CI 1.14-1.35]; P < 0.001) were related to recurrence within 6-12 months.CONCLUSION: This study demonstrates preoperative predictors that are associated with the manifestation of early and very early recurrence after PDAC resection. Knowledge of these predictors can be used to guide individualized surveillance and treatment strategies.",

keywords = "SURVIVAL, THERAPY, UPFRONT SURGERY, ADJUVANT CHEMOTHERAPY, QUALITY-OF-LIFE, GEMCITABINE",

author = "Daamen, {Lois A} and Galina Dorland and Brada, {Lilly J H} and Groot, {Vincent P} and {van Oosten}, {A Floortje} and Besselink, {Marc G} and Koop Bosscha and Bonsing, {Bert A} and Busch, {Olivier R} and Cirkel, {Geert A} and {van Dam}, {Ronald M} and Sebastiaan Festen and {Groot Koerkamp}, Bas and {Haj Mohammad}, Nadia and {van der Harst}, Erwin and {de Hingh}, {Ignace H J T} and Intven, {Martijn P W} and Geert Kazemier and Maartje Los and {de Meijer}, {Vincent E} and Nieuwenhuijs, {Vincent B} and Daphne Roos and Schreinemakers, {Jennifer M J} and Stommel, {Martijn W J} and Verdonk, {Robert C} and Verkooijen, {Helena M} and Molenaar, {I Quintus} and {van Santvoort}, {Hjalmar C} and {Dutch Pancreatic Cancer Group}",

year = "2022",

month = apr,

doi = "10.1016/j.hpb.2021.09.004",

language = "English",

volume = "24",

pages = "535--546",

journal = "HPB",

issn = "1365-182X",

publisher = "ELSEVIER SCI LTD",

number = "4",

}

Daamen, LA, Dorland, G, Brada, LJH, Groot, VP, van Oosten, AF, Besselink, MG, Bosscha, K, Bonsing, BA, Busch, OR, Cirkel, GA, van Dam, RM, Festen, S, Groot Koerkamp, B, Haj Mohammad, N, van der Harst, E, de Hingh, IHJT, Intven, MPW, Kazemier, G, Los, M, de Meijer, VE, Nieuwenhuijs, VB, Roos, D, Schreinemakers, JMJ, Stommel, MWJ, Verdonk, RC, Verkooijen, HM, Molenaar, IQ, van Santvoort, HC & Dutch Pancreatic Cancer Group 2022, 'Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma', HPB, vol. 24, no. 4, pp. 535-546. https://doi.org/10.1016/j.hpb.2021.09.004

TY - JOUR

T1 - Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma

AU - Daamen, Lois A

AU - Dorland, Galina

AU - Brada, Lilly J H

AU - Groot, Vincent P

AU - van Oosten, A Floortje

AU - Besselink, Marc G

AU - Bosscha, Koop

AU - Bonsing, Bert A

AU - Busch, Olivier R

AU - Cirkel, Geert A

AU - van Dam, Ronald M

AU - Festen, Sebastiaan

AU - Groot Koerkamp, Bas

AU - Haj Mohammad, Nadia

AU - van der Harst, Erwin

AU - de Hingh, Ignace H J T

AU - Intven, Martijn P W

AU - Kazemier, Geert

AU - Los, Maartje

AU - de Meijer, Vincent E

AU - Nieuwenhuijs, Vincent B

AU - Roos, Daphne

AU - Schreinemakers, Jennifer M J

AU - Stommel, Martijn W J

AU - Verdonk, Robert C

AU - Verkooijen, Helena M

AU - Molenaar, I Quintus

AU - van Santvoort, Hjalmar C

AU - Dutch Pancreatic Cancer Group

PY - 2022/4

Y1 - 2022/4

N2 - BACKGROUND: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy.METHODS: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection.RESULTS: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) <3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence <3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90° venous involvement on CT imaging (OR 2.93 [95% CI 1.60-5.37]; P < 0.001) were associated with recurrence within 3-6 months. A Charlson Age Comorbidity Index ≥4 (OR 1.53 [95% CI 1.09-2.16]; P = 0.02) and logCA 19-9 (OR 1.24 [95% CI 1.14-1.35]; P < 0.001) were related to recurrence within 6-12 months.CONCLUSION: This study demonstrates preoperative predictors that are associated with the manifestation of early and very early recurrence after PDAC resection. Knowledge of these predictors can be used to guide individualized surveillance and treatment strategies.

AB - BACKGROUND: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy.METHODS: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection.RESULTS: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%) <3 months, 96 patients (11%) within 3-6 months and 226 patients (27%) within 6-12 months. LogCA 19-9 (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and neoadjuvant treatment (OR 0.09 [95% CI 0.01-0.68]; P = 0.02) were associated with recurrence <3 months. LogCA 19-9 (OR 1.23 [95% CI 1.10-1.38]; P < 0.001) and 0-90° venous involvement on CT imaging (OR 2.93 [95% CI 1.60-5.37]; P < 0.001) were associated with recurrence within 3-6 months. A Charlson Age Comorbidity Index ≥4 (OR 1.53 [95% CI 1.09-2.16]; P = 0.02) and logCA 19-9 (OR 1.24 [95% CI 1.14-1.35]; P < 0.001) were related to recurrence within 6-12 months.CONCLUSION: This study demonstrates preoperative predictors that are associated with the manifestation of early and very early recurrence after PDAC resection. Knowledge of these predictors can be used to guide individualized surveillance and treatment strategies.

KW - SURVIVAL

KW - THERAPY

KW - UPFRONT SURGERY

KW - ADJUVANT CHEMOTHERAPY

KW - QUALITY-OF-LIFE

KW - GEMCITABINE

U2 - 10.1016/j.hpb.2021.09.004

DO - 10.1016/j.hpb.2021.09.004

M3 - Article

C2 - 34642090

SN - 1365-182X

VL - 24

SP - 535

EP - 546

JO - HPB

JF - HPB

IS - 4

ER -