• Ammar A Javed, Ingmar F Rompen, Iris W J M van Goor, Thomas F Stoop, Paul Andel, Omar Mahmud, Asad Saulat Fatimi, Joseph R Habib, Nabiha A Mughal, Thijs Schouten, Kelly Lafaro, Richard A Burkhart, William R Burns, SantvoortHjalmar C vanHCVDepartment of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands., DulkMarcel denMDDepartment of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.Nutrim School for Nutrition and Translational Research in Metabolism, Maastricht., Freek Daams, MieogJ Sven DJSDDepartment of Surgery, Leiden University Medical Centre, Leiden, the Netherlands., StommelMartijn W JMWJDepartment of Surgery, Radboudumc, Nijmegen, the Netherlands., Gijs A Patijn, HinghIgnace deIDeaprtment of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Sebastiaan Festen, Maarten W Nijkamp, Joost M Klaase, Daan J Lips, Jan H Wijsman, HarstErwin van derEVDepartment of Surgery, Maasstad Hospital, Rotterdam, The Netherlands., Eric Manusama, EijckCasper H J vanCHJVDepartment of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands., KoerkampBas GrootBGDepartment of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands., Geert Kazemier, Olivier R Busch, I Quintus Molenaar, Lois A Daamen, Jin He, Christopher L Wolfgang, Marc G Besselink, and Dutch Pancreatic Cancer Group and the PANC-PALS Consortium.
• Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA.
• Ann. Surg. 2024 Sep 17.

ObjectiveTo measure the rate of LTS in resected PDAC and determine the association between predictors of OS and LTS.Summary Background DataLong-term survival (>5 y, LTS) remains rare in pancreatic ductal adenocarcinoma (PDAC). Multiple predictors of overall survival (OS) are known but their association with LTS remains unclear.MethodsAn international, multicenter retrospective study was conducted. Included were patients from 2012-2019 with resected PDAC. Excluded were those with metastases at diagnosis or resection, R2 resections, and 90-day mortality. Predictors of OS were identified using multivariable Cox regression and their prevalence in patients with LTS assessed. LTS was calculated by excluding patients with shorter follow-up and predictors of LTS were identified using multivariable logistic regression.Results3,003 patients were included (27.4% received neoadjuvant chemotherapy). Elevated baseline CA19-9, high tumor grade, nodal disease, and perineural and lymphovascular invasion were negative independent predictors of OS, while receipt of adjuvant chemotherapy predicted improved OS (all P<0.05). LTS was observed in 220/2,436 patients (9.0%), of whom 198 (90%) harbored poor prognostic factors: elevated baseline CA19-9 (58.1%), poor tumor differentiation (51.0%), nodal disease (46.8%), and perineural invasion (76.0%). Of those without any of these four features, 50.0% achieved LTS as compared to 21.3%, 13.3%, 5.2%, and 3.5% in those with 1, 2, 3, or 4 features.ConclusionsThis bi-national cohort demonstrates a true LTS rate of 9.0% in resected PDAC. Clinicians should remain aware that presence of poor prognostic factors does not preclude LTS.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

6 keywords...

hide…