Main Pancreatic Duct to Parenchymal Thickness Ratio at Preoperative Imaging is Associated with Overall Survival in Upfront Resected Pancreatic Cancer

Background Pancreatic cancer induces parenchymal atrophy and duct dilation. The aim of this study was to evaluate whether these radiologic modifications are associated with outcomes. Methods Upfront pancreaticoduodenectomy patients with available preoperative contrast enhanced CT scan imaging were r...

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Bibliographic Details
Published in:Annals of surgical oncology 2020-05, Vol.27 (5), p.1606-1612
Main Authors: Sandini, Marta, Negreros-Osuna, Adrian A., Qadan, Motaz, Hank, Thomas, Patino, Manuel, Ferrone, Cristina R., Warshaw, Andrew L., Lillemoe, Keith D., Sahani, Dushyant, Castillo, Carlos Fernández-del
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - surgery
Aged
Atrophy
Chemotherapy
Computed tomography
Female
Humans
Male
Massachusetts - epidemiology
Medicine
Medicine & Public Health
Metastases
Middle Aged
Oncology
Pancreatic cancer
Pancreatic Ducts - diagnostic imaging
Pancreatic Ducts - pathology
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - surgery
Pancreatic Tumors
Pancreaticoduodenectomy
Pancreaticoduodenectomy - mortality
Patients
Preoperative Care
Prognosis
Retrospective Studies
ROC Curve
Short term
Surgery
Surgical Oncology
Survival
Survival Analysis
Tomography, X-Ray Computed
Tumors
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Summary:Background Pancreatic cancer induces parenchymal atrophy and duct dilation. The aim of this study was to evaluate whether these radiologic modifications are associated with outcomes. Methods Upfront pancreaticoduodenectomy patients with available preoperative contrast enhanced CT scan imaging were retrospectively analyzed. Thickness of the pancreas, size of the main pancreatic duct (MPD), and distance of the tumor from the ampulla were assessed. A training cohort was selected, including short- (3–12 months following surgery) and long-term (≥ 36 months) survivors. Identified survival determinants were validated in the overall cohort. Results Two-hundred-sixteen patients were analyzed. In the training cohort ( N  = 118), 68 patients (57.6%) were in the short-term and 50 (42.4%) in the long-term survival group. The short-term survival group had significantly higher CA 19–9 levels ( p  = 0.027), larger tumors (32.6 ± 12.1 mm vs. 26.5 ± 11.6 mm, p  = 0.007), poorer differentiation ( p  = 0.003), higher rate of R  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-019-08040-0