The Yonsei criteria as a clinically detectable parameter for excellent prognosis in resected left-sided pancreatic cancer: outcomes of a propensity score-matched analysis.

Abstract

BACKGROUND:

This study aimed to identify that Yonsei criteria (YC) can be regarded as a preoperative clinical parameter to predict biological behavior of the left-sided pancreatic cancer.

METHODS:

Between June 2007 and December 2014, 135 patients who underwent minimally invasive (MIS) or open distal pancreatectomy for left-sided pancreatic cancer were enrolled in this study consecutively. Perioperative short-term and long-term oncologic outcomes were analyzed according to the YC retrospectively.

RESULTS:

Fifty-four and 81 patients did and did not meet the YC, respectively. Short-term oncologic outcomes were favorable among those meeting the YC even after propensity score matching. Patients within the YC also had better disease-free and disease-specific overall survival (p < 0.05). In analysis for receiver operating characteristic curve, area under curve of CA19-9 was satisfactory only within YC group. Multivariate analysis for disease-free survival identified the YC as a strong independent prognostic factor (p < 0.05). In preoperative clinical setting, patients' survival was clearly different based on following clinical groups, such as within YC, beyond YC, and unresectable.

CONCLUSIONS:

Preoperative CT-based determined YC can predict excellent short-term and long-term oncologic outcomes. YC might have a potential role as a preoperative clinical staging for left-sided pancreatic cancer. External validations of YC based on multicenter cohorts are mandatory to confirm this oncologic significance of YC.

• Authors: Sung Hwan Lee, Ho Kyoung Hwang, Chang Moo Kang, Woo Jung Lee
• Journal: Surgical endoscopy (Surg Endosc) Vol. 31 Issue 11 Pg. 4656-4664 (11 2017) ISSN: 1432-2218 [Electronic] Germany
• PMID: 28389802 (Publication Type: Journal Article)

Topics

• Aged
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (pathology)
• Pancreas (pathology, surgery)
• Pancreatectomy (adverse effects, methods)
• Pancreatic Neoplasms (mortality, pathology, surgery)
• Patient Selection
• Prognosis
• Propensity Score
• Proportional Hazards Models
• ROC Curve
• Retrospective Studies
• Survival Rate
• Treatment Outcome