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

Lois A. Daamen; Galina Dorland; the Dutch Pancreatic Cancer Group (DPCG); 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; S (Sebastiaan) Festen; Bas Groot Koerkamp; Nadia Haj Mohammad; Erwin van der Harst; Ignace H J T de Hingh; Martijn P.M. Intven; Geert Kazemier; Maartje Los; Vincent E. De Meijer; Vincent B. Nieuwenhuijs; Daphne Roos; Jennifer M. Schreinemakers; Martijn W.J. Stommel; Robert C. Verdonk; Helena M. Verkooijen; I. Quintus Molenaar; Hjalmar C van Santvoort

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, the Dutch Pancreatic Cancer Group (DPCG), 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, S (Sebastiaan) Festen, Bas Groot Koerkamp, Nadia Haj Mohammad, Erwin van der Harst, Ignace H J T de Hingh, Martijn P.M. Intven, Geert Kazemier, Maartje LosVincent E. De Meijer, Vincent B. Nieuwenhuijs, Daphne Roos, Jennifer M. Schreinemakers, Martijn W.J. Stommel, Robert C. Verdonk, Helena M. Verkooijen, I. Quintus Molenaar, Hjalmar C van Santvoort

^*Corresponding author for this work

Surgery

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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 degrees 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 https://doi.org/10.1016/j.hpb.2021.09.004
Publication status	Published - Apr 2022
Event	Alpine Liver and Pancreatic Surgery Meeting - Madonna di Campiglio, Italy Duration: 5 Feb 2020 → 9 Feb 2020

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Daamen, L. A., Dorland, G., the Dutch Pancreatic Cancer Group (DPCG), 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., Mohammad, N. H., van der Harst, E., de Hingh, I. H. J. T., Intven, M. P. M., Kazemier, G., ... van Santvoort, H. C. (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, https://doi.org/10.1016/j.hpb.2021.09.004

@article{71514445d8b84e799a6a2e3fc22c6287,

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 degrees 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.",

author = "Daamen, {Lois A.} and Galina Dorland and {the Dutch Pancreatic Cancer Group (DPCG)} 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 Festen, {S (Sebastiaan)} and {Groot Koerkamp}, Bas and Mohammad, {Nadia Haj} and {van der Harst}, Erwin and {de Hingh}, {Ignace H J T} and Intven, {Martijn P.M.} and Geert Kazemier and Maartje Los and {De Meijer}, {Vincent E.} and Nieuwenhuijs, {Vincent B.} and Daphne Roos and Schreinemakers, {Jennifer M.} and Stommel, {Martijn W.J.} and Verdonk, {Robert C.} and Verkooijen, {Helena M.} and {Quintus Molenaar}, I. and {van Santvoort}, {Hjalmar C}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors; Alpine Liver and Pancreatic Surgery Meeting ; Conference date: 05-02-2020 Through 09-02-2020",

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 = "John Wiley & Sons Inc.",

number = "4",

}

Daamen, LA, Dorland, G, the Dutch Pancreatic Cancer Group (DPCG), 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, Mohammad, NH, van der Harst, E, de Hingh, IHJT, Intven, MPM, Kazemier, G, Los, M, De Meijer, VE, Nieuwenhuijs, VB, Roos, D, Schreinemakers, JM, Stommel, MWJ, Verdonk, RC, Verkooijen, HM, Quintus Molenaar, I & van Santvoort, HC 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, 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 - the Dutch Pancreatic Cancer Group (DPCG)

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, S (Sebastiaan)

AU - Groot Koerkamp, Bas

AU - Mohammad, Nadia Haj

AU - van der Harst, Erwin

AU - de Hingh, Ignace H J T

AU - Intven, Martijn P.M.

AU - Kazemier, Geert

AU - Los, Maartje

AU - De Meijer, Vincent E.

AU - Nieuwenhuijs, Vincent B.

AU - Roos, Daphne

AU - Schreinemakers, Jennifer M.

AU - Stommel, Martijn W.J.

AU - Verdonk, Robert C.

AU - Verkooijen, Helena M.

AU - Quintus Molenaar, I.

AU - van Santvoort, Hjalmar C

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 degrees 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 degrees 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.

UR - http://www.scopus.com/inward/record.url?scp=85116815236&partnerID=8YFLogxK

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

T2 - Alpine Liver and Pancreatic Surgery Meeting

Y2 - 5 February 2020 through 9 February 2020

ER -

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

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