Pancreatic liver metastases after curative resection combined with intraoperative radiation for pancreatic cancer.
OBJECTIVE
A high proportion of patients even after curative resection for pancreatic cancer suffer from hepatic metastases. The aim of this study was to identify clinicopathological predictors of liver metastases after surgery, retrospectively.


METHODS
Forty-one patients underwent extended radical pancreatectomy combined with intraoperative radiotherapy, which is one of the best local control methods for ductal cell carcinoma of the pancreas. Of the 41 patients, twenty-one patients regarded as being in a cancer free state after this combined therapy were studied to analyze clinicopathological predictors of hepatic metastases. Odds ratios and their 95% confidence intervals were calculated from data using logistic regression analysis. Statistical difference was considered significant at p<0.05.


RESULTS
Liver metastases after curative resection occurred in 11 patients. Preoperative biliary drainage, jaundice, elevated preoperative serum tumor-associated carbohydrate antigens levels, microscopic distal bile duct invasion, duodenal wall invasion, extrapancreatic nerve plexuses invasion were factors influencing postoperative liver metastases.


CONCLUSIONS
We found clinicopathological predictors of postoperative liver metastases. Patients with these factors require consideration in careful follow-up and perioperative adjuvant therapy for prevention of postoperative liver metastases.
Takamori
Hiroshi
H
Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University, Japan. h-takamori@fc.kuh.kumamoto-u.ac.jp
Hiraoka
Takehisa
T
Kanemitsu
Keiichiro
K
Tsuji
Tatsuya
T
D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D001918:Brachytherapy; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D004386:Duodenum / Q000473:pathology; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D010525:Peripheral Nerves / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D012044:Regression Analysis; D012307:Risk Factors
D015295:Antigens, Tumor-Associated, Carbohydrate