Lucocq, J; Joseph, N; Hawkyard, J; Haugk, B; White, S; Lye, J; Parkinson, D; ... Pandanaboyana, S; + view all Lucocq, J; Joseph, N; Hawkyard, J; Haugk, B; White, S; Lye, J; Parkinson, D; Mownah, O; Menon, K; Furukawa, T; Hirose, Y; Sasahira, N; Inoue, Y; Mittal, A; Samra, J; Sheen, A; Feretis, M; Balakrishnan, A; Ceresa, C; Davidson, B; Pande, R; Dasari, B; Roberts, K; Tanno, L; Karavias, D; Helliwell, J; Young, A; Marks, K; Nunes, Q; Urbonas, T; Silva, M; Gordon-Weeks, A; Barrie, J; Gomez, D; van Laarhoven, S; Nawara, H; Doyle, J; Bhogal, R; Harrison, E; Roalso, M; Ciprani, D; Aroori, S; Ratnayake, B; Koea, J; Capurso, G; Stättner, S; Bellotti, R; Alsaoudi, T; Bhardwaj, N; Rajesh, S; Jeffery, F; Connor, S; Cameron, A; Jamieson, N; Gill, A; Soreide, K; Pandanaboyana, S; - view fewer (2024) Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasm and derivation of a prognostic model: An international multicenter study (ADENO-IPMN study). Surgery , 176 (3) pp. 890-898. 10.1016/j.surg.2024.05.010.

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Text Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasm and derivation of a prognostic model_clean AAM with figs.pdf - Accepted Version Download (2MB) | Preview

Abstract

Background: Predictors of long-term survival after resection of adenocarcinoma arising from intraductal papillary mucinous neoplasms are unknown. This study determines predictors of long-term (>5 years) disease-free survival and recurrence in adenocarcinoma arising from intraductal papillary mucinous neoplasms and derives a prognostic model for disease-free survival. Methods: Consecutive patients who underwent pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms in 18 academic pancreatic centers in Europe and Asia between 2010 to 2017 with at least 5-year follow-up were identified. Factors associated with disease-free survival were determined using Cox proportional hazards model. Internal validation was performed, and discrimination and calibration indices were assessed. Results: In the study, 288 patients (median age, 70 years; 52% male) were identified; 140 (48%) patients developed recurrence after a median follow-up of 98 months (interquartile range, 78.4–123), 57 patients (19.8%) developed locoregional recurrence, and 109 patients (37.8%) systemic recurrence. At 5 years after resection, the overall and disease-free survival was 46.5% (134/288) and 35.0% (101/288), respectively. On Cox proportional hazards model analysis, multivisceral resection (hazard ratio, 2.20; 95% confidence interval, 1.06–4.60), pancreatic tail location (hazard ratio, 2.34; 95% confidence interval, 1.22–4.50), poor tumor differentiation (hazard ratio, 2.48; 95% confidence interval, 1.10–5.30), lymphovascular invasion (hazard ratio, 1.74; 95% confidence interval, 1.06–2.88), and perineural invasion (hazard ratio, 1.83; 95% confidence interval, 1.09–3.10) were negatively associated with long-term disease-free survival. The final predictive model incorporated 8 predictors and demonstrated good predictive ability for disease-free survival (C-index, 0.74; calibration, slope 1.00). Conclusion: A third of patients achieve long-term disease-free survival (>5 years) after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms. The predictive model developed in the current study can be used to estimate the probability of long-term disease-free survival.

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