Table 3.
Demographics, Clinicopathologic, and Treatment Characteristics of All Patients With Recurrence
| Variable | Early Recurrence <12 mo (n = 388) | Late Recurrence >12 mo (n = 365) | P Value |
|---|---|---|---|
|
| |||
| Female, n (%) | 191 (49.2%) | 177 (48.5%) | 0.840 |
| Race/ethnicity, n (%) | 0.232 | ||
| Caucasian | 325 (83.8%) | 317 (86.8%) | |
| Other | 63 (16.2%) | 48 (13.2%) | |
| Age, mean years (SD) | 65.4 (11.1) | 64.9 (9.7) | 0.457 |
| Charlson age-comorbidity index, n (%) | 0.008 | ||
| <4 points | 243 (62.6%) | 262 (71.8%) | |
| ≥4 points | 145 (37.4%) | 103 (28.2%) | |
| Preoperative CA 19–9 (U/mL)* | |||
| Median (IQR) | 221 (87–685) | 91 (30–294) | <0.001 |
| Postoperative CA 19–9 (U/mL)† | |||
| Median (IQR) | 91 (30–294) | 29 (16–60) | <0.001 |
| Operation procedure, n (%) | 0.311 | ||
| PPPD | 149 (38.4%) | 151 (41.4%) | |
| Classic PD | 163 (42.0%) | 160 (43.8%) | |
| Total pancreatectomy | 15 (3.9%) | 8 (2.2%) | |
| Distal pancreatectomy | 61 (15.7%) | 46 (12.6%) | |
| Complications, n (%) | 0.013 | ||
| Clavien-Dindo grade ≤II | 317 (81.7%) | 322 (88.2%) | |
| Clavien-Dindo grade ≥III | 71 (18.3%) | 43 (11.8%) | |
| Resection margin, n (%) | 0.126 | ||
| R0 (>1.0 mm) | 243 (62.6%) | 248 (67.9%) | |
| R1 (≤1.0 mm) | 145 (37.4%) | 117 (32.1%) | |
| Tumour differentiation, n (%) | <0.001 | ||
| Well-moderate | 202 (52.1%) | 241 (66.0%) | |
| Poor | 186 (47.9%) | 124 (34.0%) | |
| Tumour size, mean cm (SD) | 3.5 (1.5) | 3.0 (1.1) | <0.001 |
| T-stage, n (%) | 0.005 | ||
| 1–2 | 91 (23.5%) | 119 (32.6%) | |
| 3–4 | 297 (76.5%) | 246 (67.4%) | |
| Positive lymph nodes, n (%) | 322 (83.0%) | 267 (73.2%) | 0.001 |
| Positive lymph node ratio, n (%) | <0.001 | ||
| ≤0.2 | 213 (54.9%) | 259 (71.0%) | |
| >0.2 | 175 (45.1%) | 106 (29.0%) | |
| Micr. perineural invasion, n (%) | 361 (93.5%) | 335 (92.0%) | 0.430 |
| Micr. lymphovascular invasion, n (%) | 257 (68.5%) | 206 (57.4%) | 0.001 |
| AJCC stage 7th edition, n (%) | 0.001 | ||
| ≤2A | 81 (20.9%) | 114 (31.2%) | |
| ≥2B | 307 (79.1%) | 251 (68.8%) | |
| Adjuvant therapy, n (%) | <0.001 | ||
| No adjuvant | 175 (45.1%) | 77 (21.1%) | |
| Chemotherapy | 65 (16.8%) | 80 (21.9%) | |
| Chemoradiotherapy | 148 (38.1%) | 208 (57.0%) | |
| Recurrence site, n (%) | |||
| Liver only | 131 (33.8%) | 53 (14.5%) | <0.001 |
| Multiple-site | 143 (36.9%) | 110 (30.1%) | 0.050 |
| Lung only | 33 (8.5%) | 73 (20.0%) | <0.001 |
| Local only | 76 (19.6%) | 114 (31.2%) | <0.001 |
| Other | 5 (1.3%) | 15 (4.1%) | 0.016 |
*
Three hundred fifteen patients had preoperative CA 19–9 levels available for analysis. Excluded from analysis were 50 Lewis antigen negative patients and 388 patients with missing preoperative values.
†
Four hundred fifty-five patients had postoperative CA 19–9 levels available for analysis. Excluded from analysis were 50 Lewis antigen negative patients and 248 patients with missing postoperative values.
SD indicates standard deviation; CA, carbohydrate antigen; IQR, interquartile range; PPPD, pylorus-preserving pancreatoduodenectomy; PD, pancreatoduodenectomy; AJCC, American Joint Committee on Cancer; Micr, microscopic.