title: Tumor size significantly correlates with postoperative liver metastases and COX-2 expression in patients with resectable pancreatic cancer.
abstract: OBJECTIVE
  Local treatment often fails in patients with resectable pancreatic cancer due to the postoperative development of distant metastases, especially liver metastases. We determined the prognostic factors for postoperative liver metastases in pancreatic cancer patients following surgical resection with combined radiotherapy.
  
  
  METHODS
  Sixty-four patients with nonmetastatic, resectable pancreatic cancer were entered into this study. All of these patients had pancreatic resection surgery combined with radiotherapy. The development of postoperative liver metastases was carefully followed, and the survival ratio was evaluated using the Kaplan-Meier method. The prognostic importance of clinicopathological factors and molecular characteristics was analyzed by the Cox proportional hazards model. The correlation study was performed using Fisher's exact test.
  
  
  RESULTS
  Tumor size, curability, and histological type of differentiation were statistically significant independent prognostic factors. On multivariate analysis, curability and histological type of differentiation were statistically significant. Only tumor size (> or = 3 cm) was significantly correlated with postoperative liver metastases, as well as cyclooxygenase-2 expression.
  
  
  CONCLUSIONS
  There were three significant prognostic factors in patients with resectable pancreatic cancer who had local therapy. Patients who have a large tumor require particularly careful follow-up for postoperative liver metastases.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. gakussjr@kpa.biglobe.ne.jp
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsumoto
authors.forename: Mariko
authors.initials: M
authors.lastname: Muta
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Horiguchi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Karasawa
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000201:enzymology / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000201:enzymology / Q000401:mortality / Q000556:secondary*; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000201:enzymology / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human