title: Preoperative fecal elastase-1 is a useful prognostic marker following curative resection of pancreatic cancer.
abstract: The clinical relevance of fibrosis with regard to tumor progression is supported by the correlation between fibrosis and poor outcomes. Fecal elastase-1 (FE-1) level has been used to assess exocrine dysfunction of the pancreas and to predict pancreas fibrosis. The aim of this study was to assess the impact of FE-1 on the survival of pancreatic cancer patients.
  
  
  
  Between January 2006 and December 2014, 136 patients with pancreatic adenocarcinoma underwent R0 resection at Gangnam Severance Hospital, Korea. Preoperative FE-1 levels were available in 94 patients who were enrolled in the study. Patients were classified into two groups according to preoperative FE-1: "normal" (≥200 μg/g) or "reduced" (<200 μg/g).
  
  
  
  Median preoperative FE-1 level was 130.1 μg/g (IQR 32.0; 238.3). 62 patients (66.0%) had reduced pancreatic function and 32 patients (34.0%) had normal pancreatic function. The two groups had significantly different disease-free survival (P < 0.001). On multivariate analysis, normal FE-1, no lymph node metastasis and completion of adjuvant chemotherapy were found to be independent prognostic factors for better DFS (P = 0.001, P = 0.017, P = 0.038, respectively).
  
  
  
  FE-1 is a simple and non-invasive predictive clinical marker for prognosis of pancreatic cancer after attempted curative resection.
authors.affiliation: Department of Surgery, Yongin Severance Hospital, Yonsei University, Yongin, South Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Pancreas Cancer Clinics, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea.
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.affiliation: Pancreas Cancer Clinics, Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea. Electronic address: yds6110@yuhs.ac.
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D015536:Down-Regulation; D005243:Feces / Q000201:enzymology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests; D010190:Pancreatic Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D010196:Pancreatic Elastase