术前治疗后 CA19-9 的显着升高否定了可切除和边缘可切除胰腺癌根治性手术的预后益处。
A striking elevation of CA19-9 after preoperative therapy negates prognostic benefit from radical surgery in resectable and borderline resectable pancreatic cancer.
发表日期：2024 Jul 29
作者：
Hirofumi Akita, Yosuke Mukai, Masahiko Kubo, Hidenori Takahashi, Shinichiro Hasegawa, Masatoshi Kitakaze, Norihiro Matsuura, Yasunori Masuike, Takahito Sugase, Naoki Shinno, Takashi Kanemura, Hisashi Hara, Toshinori Sueda, Junichi Nishimura, Masayoshi Yasui, Takeshi Omori, Hiroshi Miyata, Masayuki Ohue, Hiroshi Wada
来源：
SURGERY
摘要：
确定可以避免进行无益手术的患者至关重要，因为胰腺癌手术具有高度侵入性，会对生活质量产生重大负面影响。该研究的目的是调查可切除和临界可切除胰腺癌新辅助治疗后未从根治性手术中获得预后获益的患者的有用指标。我们比较了 2005 年至 2005 年期间接受新辅助治疗的 609 名可切除或临界可切除胰腺癌患者的因素。 2019.患者被分为预后不良组（未手术或切除后一年内复发）和预后良好组（无复发或切除后一年以上复发）。切除后一年内复发的患者（不良预后组）预后组）的情况并不比接受新辅助治疗并出现进展但从未进行手术的患者好。新辅助治疗后糖抗原19-9的值是预测不良预后组最显着的指标，糖抗原19-9升高（>200 U/mL）只能识别不良预后组，特异性高达96.6%。糖抗原19-9超过200的患者新辅助治疗后总生存率明显非常差，2年生存率仅为41.4%。可切除或临界性新辅助治疗后糖抗原19-9显着升高可切除的胰腺癌是预后不良的良好指标。新辅助治疗后碳水化合物抗原 19-9 >200 U/mL 的患者不应接受根治性手术。版权所有 © 2024 Elsevier Inc. 保留所有权利。
Identifying patients who can be spared nonbeneficial surgery is crucial, as pancreatic cancer surgery is highly invasive, with substantial negative effects on quality of life. The study objective was to investigate a useful indicator of patients who do not gain prognostic benefit from radical surgery after neoadjuvant therapy for resectable and borderline resectable pancreatic cancer.We compared factors among 609 patients with resectable or borderline resectable pancreatic cancer receiving neoadjuvant therapy during 2005-2019. Patients were divided into a poor-prognosis group (no surgery or postresection recurrence within a year) and a good-prognosis group (no recurrence or recurrence >1 year after resection).Patients who experience a recurrence within a year of resection (poor-prognosis group) did no better than patients who received neoadjuvant therapy and progressed but never made it to surgery. The value of carbohydrate antigen 19-9 after neoadjuvant therapy was the most significant indicator to predict the poor prognosis group and the elevation of carbohydrate antigen 19-9 (>200 U/mL) identified only poor prognosis group with high specificity of 96.6%. The overall survival of patients with more than 200 of carbohydrate antigen 19-9 after neoadjuvant therapy was significantly very poor and their 2-year survival rate was only 41.4%.A striking elevation of carbohydrate antigen 19-9 after neoadjuvant therapy for resectable or borderline resectable pancreatic cancer is a good indicator of poor prognosis. Patients with carbohydrate antigen 19-9 >200 U/mL after neoadjuvant therapy should not undergo radical surgery.Copyright © 2024 Elsevier Inc. All rights reserved.