caa a22 4500 445338466 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1311-x doi (NATIONALLICENCE)springer-10.1245/s10434-010-1311-x Retrospective Evaluation of the Influence of Postoperative Tumor Marker Status on Survival and Patterns of Recurrence After Surgery for Pancreatic Cancer Based on RECIST Guidelines [Elektronische Daten] [Fuyuhiko Motoi, Toshiki Rikiyama, Yu Katayose, Shin-ichi Egawa, Michiaki Unno] Purpose: The purpose of this study was to obtain a comprehensive understanding of the impact of postoperative tumor marker (TM) normalization on survival after pancreatectomy for pancreatic carcinoma. We propose the concept of surgical RECIST based on residual tumor and TM status. Methods: A total of consecutive patients with pancreatic carcinoma underwent pancreatectomy between August 1, 1989, and August 1, 2008. Pre- and postoperative TM values were available for 194 patients. The relationship between TM status, survival, and other clinical and demographic data was determined with univariate log-rank tests and Cox proportional hazards analysis. Results: Postoperative TM levels remained elevated in 92 patients (47.4%; partial responders). TM levels normalized in 102 patients (52.6%; complete responders). Lymph node metastases, portal vein resection, absence of retroperitoneal clearance, residual tumor, preoperative high CA19-9, and surgical partial response were associated with decreased survival. Nodal stage (P=0.0227) and surgical RECIST (P=0.025) were significant predictors of survival. Partial responders had a significantly lower median survival time (P=0.0008) and significantly higher frequency of hepatic metastasis (P=0.0299). Conclusions: Postresection TM normalization is a strong prognostic factor for pancreatic cancer. The efficacy of pancreatic cancer surgery should be evaluated in the context of both local clearance and serum TM kinetics. Society of Surgical Oncology, 2010 Motoi Fuyuhiko Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut Rikiyama Toshiki Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut Katayose Yu Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut Egawa Shin-ichi Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut Unno Michiaki Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 371-379 1068-9265 18:2<371 2011 18 10434 https://doi.org/10.1245/s10434-010-1311-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1311-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Motoi Fuyuhiko Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut NATIONALLICENCE 700 1- Rikiyama Toshiki Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut NATIONALLICENCE 700 1- Katayose Yu Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut NATIONALLICENCE 700 1- Egawa Shin-ichi Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut NATIONALLICENCE 700 1- Unno Michiaki Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 371-379 1068-9265 18:2<371 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer