Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma
Abstract
1. Introduction
2. Methods
2.1. Study Population
2.2. Adjuvant Therapy
2.3. Follow-Up and Recurrence
2.4. Statistical Analysis
3. Results
Perioperative Risk Factor Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients (n = 163) | Head-Neck (n = 126) | Body-Tail (n = 37) | p-Value | |
---|---|---|---|---|
Male, n (%) | 92 (56.4) | 72 (57.1) | 20 (54.1) | 0.73 |
Age, years, mean (SD) <70 years old >70 years old | 61 (9) 137 (84) 26 (16) | 61 (9) 107 (84.9) 19 (15.1) | 60 (8) 30 (81.1) 7 (18.9) | 0.57 |
ECOG, n (%) 0 1–2 | 101 (62.7) 60 (37.3) | 77 (62.1) 47 (37.9) | 24 (64.9) 13 (35.1) | 0.76 |
Charlson comorbidity index, median (IQR) | 2 (1–4) | 2 (1–4) | 2 (1–4) | 0.92 |
Preoperative CA19-9 level (U/mL), median (IQR) | 294 (64–954) | 225 (64–892) | 464 (59–2021) | 0.46 |
Pathological tumor size, mean (SD) | 3.5 (1.5) | 3.5 (1.2) | 4.5 (1.8) | 0.03 |
T stage, n (%) T1–T2 T3–T4 | 42 (25.8) 121 (74.2) | 32 (25.4) 94 (74.6) | 10 (27) 27 (73) | 0.83 |
Positive lymph nodes, n (%) | 126 (77.3) | 95 (75.4) | 31 (83.8) | 0.37 |
TNM stage, n (%) Stage 1–2 Stage 3–4 | 103 (63.1) 60 (26.9) | 82 (65.1) 44 (34.9) | 21 (56.8) 16 (43.2) | 0.43 |
Residual tumor, n (%) R0 R1 | 87 (53.4) 76 (46.6) | 61 (48.4) 65 (51.6) | 26 (70.3) 11 (29.7) | 0.02 |
Differentiation, n (%) well modified-poor | 84 (54.5) 70 (45.5) | 62 (51.2) 59 ((48.8) | 22 (66.7) 11 (33.3) | 0.16 |
Lymphovascular invasion, n (%) | 127 (80.4) | 98 (80.3) | 29 (80.6) | 0.97 |
Perineural invasion, n (%) | 145 (92.4) | 112 (92.6) | 33 (91.7) | 0.85 |
Adjuvant CT, n (%) | 131 (80.3) | 103 (83.7) | 28 (75.6) | 0.41 |
ER Group (n = 58) | NER Group (n = 80) | p-Value | |
---|---|---|---|
Liver | 8 (13.8) | 18 (22.5) | p > 0.05 |
Lung | 5 (8.6) | 11 (13.8) | p > 0.05 |
Peritoneum | 3 (5.2) | 7 (8.8) | p > 0.05 |
Local | 3 (5.2) | 7 (8.8) | p > 0.05 |
More than 2 different region metastasis | 39 (67.2) | 37 (46.3) | p = 0.014 |
Preoperative Risk Factors | Univariate OR (95%) p Value | Multivariate OR (95%) p Value | ||
---|---|---|---|---|
Age (>70 vs. <70 years | 2.02 (0.86–4.72) | 0.103 | ||
Gender (male vs. female) | 1.63 (0.84–3.15) | 0.146 | ||
Charlson Comorbidity Index (>4 vs. <4) | 1.85 (0.87–3.93) | 0.108 | ||
Tumor location (head/neck vs. body/tail) | 2.69 (1.27–5.70) | 0.010 | 2.55 (0.90–7.23) | 0.076 |
ECOG (0 vs. 1–2) | 1.86 (0.95–3.63) | 0.068 | 3.31 (1.28–8.55) | 0.013 |
Preoperative CA 19.9 (<208 U/mL vs. >208 U/mL) | 4.21 (1.66–10.71) | 0.002 | 3.18 (1.18–8.57) | 0.022 |
Postoperative Risk Factors | Univariate OR (95%) p-Value | Multivariate OR (95%) p-Value | ||
---|---|---|---|---|
Residual tumor (R0 vs. R1) | 2.43 (1.2–4.7) | 0.008 | 2.13 (0.85–5.35) | 0.107 |
LVI (yes vs. no) | 4.9 (1.61–14.84) | 0.005 | ||
PNI (yes vs. no) | 0.14 (0.01–1.17) | 0.070 | ||
Tumor differentiation (well vs. modified/poor) | 2.08 (1.05–4.1) | 0.035 | 2.11 (0.84–5.28) | 0.109 |
Tumor location (head vs. body/tail) | 2.69 (1.27–5.70) | 0.010 | 3.23 (1.08–9.64) | 0.035 |
Tumor size (pathologically, <3.25 cm vs. >3.25 cm) | 3.84 (1.77–8.31) | 0.001 | 3.32 (1.21–9.04) | 0.019 |
LNR (<0.13 vs. >0.13) | 2.82 (1.33–5.99) | 0.007 | 3.49 (1.34–9.08) | 0.010 |
Adjuvant chemotherapy (yes vs. no) | 5.74 (2.47–13.31) | <0.001 | 6.63 (1.81–24.72) | 0.004 |
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Caliskan Yildirim, E.; Unek, I.T.; Oztop, I.; Uzun, M.; Unek, T.; Sagol, O. Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma. Medicina 2025, 61, 1799. https://doi.org/10.3390/medicina61101799
Caliskan Yildirim E, Unek IT, Oztop I, Uzun M, Unek T, Sagol O. Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma. Medicina. 2025; 61(10):1799. https://doi.org/10.3390/medicina61101799
Chicago/Turabian StyleCaliskan Yildirim, Eda, Ilkay Tugba Unek, Ilhan Oztop, Mehmet Uzun, Tarkan Unek, and Ozgul Sagol. 2025. "Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma" Medicina 61, no. 10: 1799. https://doi.org/10.3390/medicina61101799
APA StyleCaliskan Yildirim, E., Unek, I. T., Oztop, I., Uzun, M., Unek, T., & Sagol, O. (2025). Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma. Medicina, 61(10), 1799. https://doi.org/10.3390/medicina61101799