Clinical Predictors of Unresectable Disease at Laparotomy in Patients With Pancreatic Ductal Adenocarcinoma Planning to Undergo Surgical Resection.
BACKGROUND/AIM
Computed tomography and positron emission tomography cannot detect all minute distant metastases and fully evaluate extensive vascular invasion in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to investigate predictors of laparotomy only and palliative surgery in PDAC patients planning surgical resection.


PATIENTS AND METHODS
We reviewed 239 PDAC patients planning surgical resection. Patients were divided into two groups based on resection status. Multivariate analyses were performed to identify predictors of unresectable disease at laparotomy.


RESULTS
Twenty-five patients had unresectable disease at laparotomy. Multivariate analysis revealed that anatomical borderline resectable status (yes/no) (HR=5.458, p=0.012), pretreatment CA19-9 (>260/≤260 ng/ml) (HR=4.907, p=0.041), and tumor size (>25/≤25 mm) (HR=21.42, p=0.004) were associated with unresectable disease at laparotomy.


CONCLUSION
Borderline resectable status, pretreatment CA19-9, and tumor size were closely associated with unresectable disease at laparotomy in PDAC patients planning surgical resection.
['Shimizu|Takayuki|T|', 'Aoki|Taku|T|', 'Sato|Shun|S|', 'Matsumoto|Takatsugu|T|', 'Shiraki|Takayuki|T|', 'Sakuraoka|Yuhki|Y|', 'Mori|Shozo|S|', 'Iso|Yukihiro|Y|', 'Ishizuka|Mitsuru|M|', 'Kubota|Keiichi|K|']
D000230:Adenocarcinoma D000368:Aged D018395:CA-19-9 Antigen D021441:Carcinoma, Pancreatic Ductal D005260:Female D005500:Follow-Up Studies D006801:Humans D007813:Laparotomy D008297:Male D010190:Pancreatic Neoplasms D011300:Preoperative Care D011379:Prognosis D012372:ROC Curve D012189:Retrospective Studies
Pancreatic ductal adenocarcinoma CA19-9 maximum tumor size unresectable disease at laparotomy borderline resectable