• Stefano Crippa, Giuseppe Malleo, Serena Langella, Claudio Ricci, Fabio Casciani, Giulio Belfiori, Sara Galati, Carlo Ingaldi, Gabriella Lionetto, Alessandro Ferrero, Riccardo Casadei, Giorgio Ercolani, Roberto Salvia, Massimo Falconi, and Alessandro Cucchetti.
• Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
• Ann. Surg. 2023 Dec 4.

ObjectiveTo assess the probability of being cured from pancreatic ductal adenocarcinoma (PDAC) by pancreatic surgery.Summary Background DataStatistical cure implies that a patient treated for a specific disease will have the same life expectancy as if he/she never had that disease.MethodsPatients who underwent pancreatic resection for PDAC between 2010 and 2021 were retrospectively identified using a multi-institutional database. A non-mixture statistical cure model was applied to compare disease-free survival to the survival expected for matched general population.ResultsAmong 2554 patients, either in the setting of upfront (n=1691) or neoadjuvant strategy (n=863), the cure model showed that the probability that surgery would offer the same life-expectancy (and tumor-free) as the matched general population was 20.4% (95%CI: 18.3, 22.5). Cure likelihood reached the 95% of certainty (time-to-cure) after 5.3 years (95%CI: 4.7, 6.0). A preoperative model was developed based on tumor stage at diagnosis (P=0.001), radiological size (P=0.001), response to chemotherapy (P=0.007), American Society of Anesthesiology class (P=0.001) and pre-operative Ca19-9 (P=0.001). A post-operative model with the addition of surgery type (P=0.015), pathological size (P=0.001), tumour grading (P=0.001), resection margin (P=0.001), positive lymphnode ratio (P=0.001) and the receipt of adjuvant therapy (P=0.001) was also developed.ConclusionsPatients operated for PDAC can achieve a life-expectancy similar to that of general population and the likelihood of cure increases with the passage of recurrence-free time. An online calculator was developed and available at https://aicep.website/?cff-form=15.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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