Total pancreatectomy for NET pancreas: early experience with the 'Artery-First' approach at a tertiary care centre in India

Abstract

Results: PostCA19-9 were measured within 3 months after surgery (20-88 days, median; 43 days). Group C patients showed significantly poorer survival (group A/B/C; 3-year OS 61.9% /53.4% /12.4%; median survival time 44.2m /37.3m/ 13.6m; p< 0.001). The early recurrence rate within 6 month (p< 0.001) and the frequency of liver metastasis (p=0.009) were significantly higher in Group C. Multivariate analysis revealed that without adjuvant chemotherapy (HR=3.29; p< 0.001), preoperative-CT tumor size>20mm (HR=2.76; p< 0.001) and sustained elevation of postCA19-9 (HR=2.49; p=0.0017) were the independent significant prognostic factors for poor survival. The ROC curve analysis revealed that the optimal cut-off value of preCA19-9 which predict postCA19-9 normalization was 116 U/ml. Conclusion: Sustained elevation of postCA19-9 is a strong prognostic factor for R-PDAC. Patients with preCA19-9>120 could be considered the existence of potential distant metastasis (especially liver metastasis).