Primary Recurrence in the Lung is Related to Favorable Prognosis in Patients with Pancreatic Cancer and Postoperative Recurrence
Primary Recurrence in the Lung is Related to Favorable Prognosis in Patients with Pancreatic Cancer and Postoperative Recurrence
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DOI：
10.1007/s00268-017-4068-6
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发表时间：
2017-11-01
影响因子：
2.6
通讯作者：
Nakamura, Masafumi
中科院分区：
文献类型：
--
作者：
Zheng, Biao;Ohuchida, Kenoki;Nakamura, Masafumi
复发模式影响肿瘤患者的临床结局。然而，肺转移作为胰腺癌患者切除术后原发复发部位的临床意义仍不清楚。本研究旨在探讨胰腺癌原发灶复发的临床意义，包括胰腺癌切除术后复发的220例患者，并根据原发灶复发进行分类。我们重点研究了以肺转移为原发复发的患者，并探讨了其与预后和临床病理因素的关系。这种复发模式是所有复发模式中预后最好的，包括肝转移和局部复发。在单因素分析（P = 0.0008和P = 0.0005）和多因素分析（P = 0.0051和P = 0.0068）中，与其他原发性复发部位的患者相比，肺转移作为原发性复发部位的患者的总生存率和自复发之日起的生存率较好。从胰腺癌术后复发的临床病理特征来看，以肺转移为原发灶的胰腺癌患者的分期、组织学分级较低，血管侵犯和残留肿瘤体积较肝转移少，胰腺癌术后以肺转移为原发灶的胰腺癌患者预后较好。
The pattern of recurrence affects the clinical outcome in tumor patients. However, the clinical significance of lung metastasis as the primary recurrence site after resection in patients with pancreatic cancer remains unclear. This study aimed to clarify the clinical significance of the primary recurrence site in patients with pancreatic cancer, in terms of prognosis and clinicopathological features.This retrospective cohort study included 220 patients with postoperative recurrence after pancreatectomy for pancreatic cancer and classified by primary site of recurrence. We focused on patients with lung metastasis as the primary recurrence and investigated its correlation with prognosis and clinicopathological factors.Twenty-four (11%) patients had lung metastasis as the primary recurrence. This recurrence pattern had the best prognosis among all recurrence patterns, including liver metastasis and local recurrence. Patients with lung metastasis as the primary recurrence had favorable overall survival and survival from the date of recurrence compared with patients with other primary recurrence sites in both univariate (P = 0.0008 and P = 0.0005) and multivariate analyses (P = 0.0051 and P = 0.0068). In terms of clinicopathological features of resected pancreatic tumors, lung metastasis as the primary recurrence was associated with lower tumor stage and histologic grade, and less vascular invasion and residual tumor volume than liver metastasis.Pancreatic cancer patients with lung metastasis as the primary recurrence after pancreatectomy have a better prognosis than those with other recurrence patterns.