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Risk factors and outcomes for patients with pancreatic cancer undergoing surgical exploration without resection due to metastatic disease : A national cohort study

Sahlström, Emil LU ; Bereza-Carlson, Paulina LU ; Nilsson, Johan LU orcid ; Tingstedt, Bobby LU and Andersson, Bodil LU orcid (2022) In Hepatobiliary and Pancreatic Diseases International 21(3). p.279-284
Abstract

Background: Unresectable disease is sometimes diagnosed during surgery in patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify preoperative risk factors for metastatic disease diagnosed at surgical exploration and to investigate and compare survival in resected and non-resected patients. Methods: Patients were identified from the Swedish National Pancreatic and Periampullary Cancer Registry 2010-2018. Predictors of metastatic disease were evaluated with a multivariable logistic regression model, and survival was evaluated with Kaplan-Meier estimates and log-rank tests. Results: In total, 1938 patients with PDAC were scheduled for surgery. An unresectable situation was diagnosed intraoperatively in 399... (More)

Background: Unresectable disease is sometimes diagnosed during surgery in patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify preoperative risk factors for metastatic disease diagnosed at surgical exploration and to investigate and compare survival in resected and non-resected patients. Methods: Patients were identified from the Swedish National Pancreatic and Periampullary Cancer Registry 2010-2018. Predictors of metastatic disease were evaluated with a multivariable logistic regression model, and survival was evaluated with Kaplan-Meier estimates and log-rank tests. Results: In total, 1938 patients with PDAC were scheduled for surgery. An unresectable situation was diagnosed intraoperatively in 399 patients (20.6%), including 234 (12.1%) with metastasized disease. Independent risk factors for metastasis were involuntary weight loss (OR = 1.72; 95% CI: 1.27-2.33) and elevated carbohydrate antigen 19-9 (CA19-9) (35-599 U/mL, OR = 1.79, 95% CI: 1.11-2.89; ≥ 600 U/mL, OR = 3.24, 95% CI: 2.04-5.17). Overall survival was lower among patients with metastasized disease than that among patients with a resectable tumor (P < 0.001). Conclusions: Involuntary weight loss and an elevation of CA19-9 are preoperative risk factors for diagnosing metastasized disease during surgical exploration.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Exploration, Metastasized, Pancreatic cancer, Surgery
in
Hepatobiliary and Pancreatic Diseases International
volume
21
issue
3
pages
279 - 284
publisher
Elsevier
external identifiers
  • scopus:85125445092
  • pmid:35248479
ISSN
1499-3872
DOI
10.1016/j.hbpd.2022.02.003
language
English
LU publication?
yes
id
37538c00-3fae-4d1b-8b5e-6e942d303587
date added to LUP
2022-04-19 13:56:23
date last changed
2024-06-15 18:27:46
@article{37538c00-3fae-4d1b-8b5e-6e942d303587,
  abstract     = {{<p>Background: Unresectable disease is sometimes diagnosed during surgery in patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify preoperative risk factors for metastatic disease diagnosed at surgical exploration and to investigate and compare survival in resected and non-resected patients. Methods: Patients were identified from the Swedish National Pancreatic and Periampullary Cancer Registry 2010-2018. Predictors of metastatic disease were evaluated with a multivariable logistic regression model, and survival was evaluated with Kaplan-Meier estimates and log-rank tests. Results: In total, 1938 patients with PDAC were scheduled for surgery. An unresectable situation was diagnosed intraoperatively in 399 patients (20.6%), including 234 (12.1%) with metastasized disease. Independent risk factors for metastasis were involuntary weight loss (OR = 1.72; 95% CI: 1.27-2.33) and elevated carbohydrate antigen 19-9 (CA19-9) (35-599 U/mL, OR = 1.79, 95% CI: 1.11-2.89; ≥ 600 U/mL, OR = 3.24, 95% CI: 2.04-5.17). Overall survival was lower among patients with metastasized disease than that among patients with a resectable tumor (P &lt; 0.001). Conclusions: Involuntary weight loss and an elevation of CA19-9 are preoperative risk factors for diagnosing metastasized disease during surgical exploration.</p>}},
  author       = {{Sahlström, Emil and Bereza-Carlson, Paulina and Nilsson, Johan and Tingstedt, Bobby and Andersson, Bodil}},
  issn         = {{1499-3872}},
  keywords     = {{Exploration; Metastasized; Pancreatic cancer; Surgery}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{279--284}},
  publisher    = {{Elsevier}},
  series       = {{Hepatobiliary and Pancreatic Diseases International}},
  title        = {{Risk factors and outcomes for patients with pancreatic cancer undergoing surgical exploration without resection due to metastatic disease : A national cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.hbpd.2022.02.003}},
  doi          = {{10.1016/j.hbpd.2022.02.003}},
  volume       = {{21}},
  year         = {{2022}},
}