Analysis of risk factors associated with distant metastasis detected at laparotomy in patients with radiologically resectable pancreatic ductal adenocarcinoma
Abstract
Purpose
This study aimed to evaluate the preoperative risk factors in patients with radiologically resectable pancreatic ductal adenocarcinomas (PDACs), deemed to be unresectable intraoperatively.
Methods
Data on patients radiologically diagnosed with resectable PDACs and subsequently underwent pancreatectomy between January 2020 and December 2021 were retrospectively collected. Preoperative risk factors were also analysed.
Results
Fifty-three patients with resectable PDAC who underwent laparotomy for curative intent were divided into the no-metastases (n = 32) and distant metastases (n = 21) groups. Univariate analysis identified factors associated with distant metastases found intraoperatively, such as significant weight loss (odds ratio [OR] 5.29, P = .02), tumour size >35 mm (OR 4.15, P = .017), tumours located at the body and tail of the pancreas (OR 6, P = .041), superior mesenteric vein (SMV) abutment from the tumour (OR 7.5, P = .02), serum carbohydrate antigen 19-9 > 385 IU/mL (OR 3.58, P = .031) and serum carcinoembryonic antigen (CEA) levels >9 IU/mL. However, multivariate analysis showed that only significant weight loss (adjusted OR 27.19, P = .011), SMV abutment from the tumour (adjusted OR 52.64, P = .01) and serum CEA levels >9 IU/mL were associated with distant metastases found intraoperatively.
Conclusion
Significant weight loss, SMV abutment and serum CEA levels of >9 IU/mL were intraoperatively associated with distant metastases. Staging laparoscopy and positron emission tomography–computed tomography may reduce unnecessary laparotomies and change clinical management in these patients.
CONFLICT OF INTEREST STATEMENT
The authors declare that they have no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data are available from the corresponding author upon reasonable request.
