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Original Articles
- Gastrointestinal cancer
- Risk Stratification of Pancreatic Ductal Adenocarcinoma Patients Undergoing Curative-Intent Surgery after Neoadjuvant Therapy
- Hyun Kyung Yang, Mi-Suk Park, Kyunghwa Han, Geonsik Eom, Yong Eun Chung, Jin-Young Choi, Seungmin Bang, Chang Moo Kang, Jinsil Seong, Myeong-Jin Kim
- Cancer Res Treat. 2024;56(1):247-258. Published online August 22, 2023
- DOI: https://doi.org/10.4143/crt.2023.586
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Abstract
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Supplementary Material
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ePub - Purpose
Clinical prognostic criteria using preoperative factors were not developed for post–neoadjuvant therapy (NAT) surgery of pancreatic ductal adenocarcinoma (PDAC). We aimed to identify preoperative factors associated with overall survival (OS) in PDAC patients who underwent post-NAT curative-intent surgery and develop risk stratification criteria.
Materials and Methods
Consecutive PDAC patients who underwent post-NAT curative-intent surgeries between 2007 and 2020 were retrospectively analyzed. Demographic, laboratory, surgical, and histopathologic variables were collected. Baseline, preoperative, and interval changes of computed tomography (CT) findings proposed by the Society of Abdominal Radiology and the American Pancreatic Association were analyzed. Cox proportional hazard analysis was used to select preoperative variables associated with OS. We developed risk stratification criteria composed of the significant preoperative variables, i.e., post-NAT response criteria. We compared the discrimination performance of post-NAT response criteria with that of post-NAT pathological (yp) American Joint Cancer Committee TNM staging system.
Results
One hundred forty-five PDAC patients were included. Stable or increased tumor size on CT (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.58 to 4.21; p < 0.001) and elevated preoperative carbohydrate antigen 19-9 (CA19-9) level (HR, 1.98; 95% CI, 1.11 to 3.55; p=0.021) were independent factors of OS. The OS of the patient groups stratified by post-NAT response criteria which combined changes in tumor size and CA19-9 showed significant difference (p < 0.001). Such stratification was comparable to ypTNM staging in discrimination performance (difference of C-index, 0.068; 95% CI, –0.012 to 0.142).
Conclusion
“Any degree of decrease in tumor size on CT” and CA19-9 normalization or staying normal were independent favorable factors of OS. The combination of the two factors discriminated OS comparably to ypTNM staging. -
Citations
Citations to this article as recorded by
- Prognostic factors in localized pancreatic ductal adenocarcinoma after neoadjuvant therapy and resection: a systematic review and meta-analysis
Ammar A Javed, Alyssar Habib, Omar Mahmud, Asad Saulat Fatimi, Mahip Grewal, Nabiha Mughal, Jin He, Christopher L Wolfgang, Lois Daamen, Marc G Besselink
JNCI: Journal of the National Cancer Institute.2024;[Epub] CrossRef
- Prognostic factors in localized pancreatic ductal adenocarcinoma after neoadjuvant therapy and resection: a systematic review and meta-analysis
- 3,083 View
- 171 Download
- 1 Web of Science
- 1 Crossref
- Intraindividual Comparison of MRIs with Extracellular and Hepatobiliary Contrast Agents for the Noninvasive Diagnosis of Hepatocellular Carcinoma Using the Korean Liver Cancer Association–National Cancer Center 2022 Criteria
- Ja Kyung Yoon, Dai Hoon Han, Sunyoung Lee, Jin-Young Choi, Gi Hong Choi, Do Young Kim, Myeong-Jin Kim
- Cancer Res Treat. 2023;55(3):939-947. Published online February 10, 2023
- DOI: https://doi.org/10.4143/crt.2022.1645
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Abstract
PDFSupplementary MaterialPubReaderePub
- Purpose
The aim of the present study was to evaluate the per-lesion sensitivity and specificity of the Korean Liver Cancer Association–National Cancer Center (KLCA-NCC) 2022 criteria for the noninvasive diagnosis of hepatocellular carcinoma (HCC), with intraindividual comparison of the diagnostic performance of magnetic resonance imaging with extracellular agents (ECA-MRI) and hepatobiliary agents (HBA-MRI).
Materials and Methods
Patients at high risk for HCC who were referred to a tertiary academic institution for hepatic lesions with size ≥ 10 mm between July 2019 and June 2022 were enrolled. A total of 91 patients (mean age, 58.1 years; 76 men and 15 women) with 118 lesions who underwent both ECA-MRI and HBA-MRI were eligible for final analysis. The per-lesion sensitivities and specificities of the KLCA-NCC 2022 criteria using ECA-MRI and HBA-MRI were compared using McNemar’s test.
Results
The 118 lesions were 93 HCCs, 4 non-HCC malignancies, and 21 benign lesions. On HBA-MRI, the “definite” HCC category showed significantly higher sensitivity than ECA-MRI (78.5% vs. 58.1%, p < 0.001), with identical specificity (92.0% vs. 92.0%, p > 0.999). For “probable” or “definite” HCC categories, there were no differences in the sensitivity (84.9% vs. 84.9%, p > 0.999) and specificity (84.0% vs. 84.0%, p > 0.999) between ECA-MRI and HBA-MRI.
Conclusion
The “definite” HCC category of the KLCA-NCC 2022 criteria showed higher sensitivity in diagnosing HCC on HBA-MRI compared with ECA-MRI, without compromising specificity. There were no significant differences in the sensitivity and specificity of “probable” or “definite” HCC categories according to ECA-MRI and HBA-MRI. -
Citations
Citations to this article as recorded by- Intraindividual comparison of prognostic imaging features of HCCs between MRIs with extracellular and hepatobiliary contrast agents
Ja Kyung Yoon, Dai Hoon Han, Sunyoung Lee, Jin‐Young Choi, Gi Hong Choi, Do Young Kim, Myeong‐Jin Kim
Liver International.2024; 44(10): 2847. CrossRef
- Intraindividual comparison of prognostic imaging features of HCCs between MRIs with extracellular and hepatobiliary contrast agents
- 4,115 View
- 149 Download
- 1 Web of Science
- 1 Crossref
- Incremental Role of Pancreatic Magnetic Resonance Imaging after Staging Computed Tomography to Evaluate Patients with Pancreatic Ductal Adenocarcinoma
- Hye Jin Kim, Mi-Suk Park, Jin Yong Lee, Kyunghwa Han, Yong Eun Chung, Jin-Young Choi, Myeong-Jin Kim, Chang Moo Kang
- Cancer Res Treat. 2019;51(1):24-33. Published online February 5, 2018
- DOI: https://doi.org/10.4143/crt.2017.404
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Abstract
PDFSupplementary MaterialPubReaderePub
- Purpose
The purpose of this study was to investigate the impact of contrast enhanced pancreatic magnetic resonance imaging (MRI) in resectability and prognosis evaluation after staging computed tomography (CT) in patients with pancreatic ductal adenocarcinoma (PDA).
Materials and Methods
From January 2005 to December 2012, 298 patients were diagnosed to have potentially resectable stage PDA on CT. Patients were divided into CT+MR (patients underwent both CT and MRI; n=216) and CT only groups (n=82). Changes in resectability staging in the CT+MR group were evaluated. The overall survival was compared between the two groups. The recurrence-free survival and median time to liver metastasis after curative surgery were compared between the two groups.
Results
Staging was changed from resectable on CT to unresectable state on MRI in 14.4% of (31 of 216 patients) patients of the CT+MR group. The overall survival and recurrence-free survival rates were not significantly different between the two groups (p=0.162 and p=0.721, respectively). The median time to liver metastases after curative surgery in the CT+MR group (9.9 months) was significantly longer than that in the CT group (4.2 months) (p=0.011).
Conclusion
Additional MRI resulted in changes of resectability and treatment modifications in a significant proportion of patients who have potentially resectable state at CT and in prolonged time to liver metastases in patients after curative surgery. Additional MRI to standard staging CT can be recommended for surgical candidates of PDA. -
Citations
Citations to this article as recorded by- Pancreatic ductal adenocarcinoma: the latest on diagnosis, molecular profiling, and systemic treatments
Doaa Bugazia, Ebtesam Al-Najjar, Abdullah Esmail, Saifudeen Abdelrahim, Karen Abboud, Adham Abdelrahim, Godsfavour Umoru, Hashem A. Rayyan, Ala Abudayyeh, Ala-Eddin Al Moustafa, Maen Abdelrahim
Frontiers in Oncology.2024;[Epub] CrossRef - S3-Leitlinie Exokrines Pankreaskarzinom – Version 3.1
Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2024; 62(10): e874. CrossRef - S3-Leitlinie Exokrines Pankreaskarzinom – Version 3.1
Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2024; 62(10): 1724. CrossRef - Additional MRI for initial M-staging in pancreatic cancer: a cost-effectiveness analysis
Felix G. Gassert, Sebastian Ziegelmayer, Johanna Luitjens, Florian T. Gassert, Fabian Tollens, Johann Rink, Marcus R. Makowski, Johannes Rübenthaler, Matthias F. Froelich
European Radiology.2022; 32(4): 2448. CrossRef - Diagnostik beim Pankreaskarzinom – Update in der neuen Leitlinie
L. Grenacher, M. Juchems, A. G. Schreyer, J. Wessling, K. I. Ringe, W. Uhl, J. Mayerle, T. Seufferlein
Der Chirurg.2022; 93(5): 429. CrossRef - Pancreatic adenocarcinoma: imaging techniques for diagnosis and management
Jawaad Farrukh, Ravivarma Balasubramaniam, Anitha James, Sharan S Wadhwani, Raneem Albazaz
British Journal of Hospital Medicine.2022; 83(5): 1. CrossRef - S3-Leitlinie zum exokrinen Pankreaskarzinom – Kurzversion 2.0 – Dezember 2021, AWMF-Registernummer: 032/010OL
Thomas Seufferlein, Julia Mayerle, Stefan Böck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2022; 60(06): 991. CrossRef - S3-Leitlinie zum exokrinen Pankreaskarzinom – Langversion 2.0 – Dezember 2021 – AWMF-Registernummer: 032/010OL
Thomas Seufferlein, Julia Mayerle, Stefan Böck, Thomas Brunner, Thomas J. Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl
Zeitschrift für Gastroenterologie.2022; 60(11): e812. CrossRef - The Role of Imaging in Current Treatment Strategies for Pancreatic Adenocarcinoma
Hyungjin Rhee, Mi-Suk Park
Korean Journal of Radiology.2021; 22(1): 23. CrossRef - A Comparative Study of Survivor Outcomes between Preoperative Evaluation Using CT Alone and Combined CT and MRI in Patients with Pancreatic Ductal Adenocarcinoma
Ji Eun Lee, Seong Hyun Kim, Soon Jin Lee, Seo-Youn Choi, Sunyoung Lee, Bo Ra Lee
Journal of the Korean Society of Radiology.2021; 82(3): 638. CrossRef - СT and MRI in the assessment of resectable and borderline resectable pancreatic tumors
A. V. Kudryavtseva, S. S. Bagnenko, I. I. Dzidzawa, I. S. Zheleznyak, G. E. Trufanov, V. V. Ryazanov, V. A. Krasovskaya, A. B. Kotiv, A. D. Kazakov
Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2021; 26(1): 34. CrossRef - European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Pancreatic Cancer
Stefano Partelli, Francesco Sclafani, Sorin Traian Barbu, Marc Beishon, Pierluigi Bonomo, Graça Braz, Filippo de Braud, Thomas Brunner, Giulia Martina Cavestro, Mirjam Crul, Maria Die Trill, Piero Ferollà, Ken Herrmann, Eva Karamitopoulou, Cindy Neuzillet
Cancer Treatment Reviews.2021; 99: 102208. CrossRef - ISOlation Procedure vs. conventional procedure during Distal Pancreatectomy (ISOP-DP trial): study protocol for a randomized controlled trial
Ken-ichi Okada, Manabu Kawai, Seiko Hirono, Masayuki Sho, Masaji Tani, Ippei Matsumoto, Suguru Yamada, Ryosuke Amano, Hirochika Toyama, Yo-ichi Yamashita, Takeshi Gocho, Kazuto Shibuya, Minako Nagai, Hiromitsu Maehira, Keiko Kamei, Go Ohira, Yoshihiro Shi
Trials.2021;[Epub] CrossRef - Management of Primary Squamous Cell Carcinoma of the Pancreas: A Case Report
Danling Guo, Chao Chen, Sangying Lv, Guanzuan Wu, Wei Shi, Huaifeng Li, Hongjie Hu
Frontiers in Surgery.2021;[Epub] CrossRef - Tumor-Specific miRNA Signatures in Combination with CA19-9 for Liquid Biopsy-Based Detection of PDAC
Min Woo Kim, Hani Koh, Jee Ye Kim, Suji Lee, Hyojung Lee, Young Kim, Ho Kyoung Hwang, Seung Il Kim
International Journal of Molecular Sciences.2021; 22(24): 13621. CrossRef - Imaging and Management of Pancreatic Cancer
Mariya Kobi, Gregory Veillette, Roshni Narurkar, David Sadowsky, Viktoriya Paroder, Chaitanya Shilagani, Anthony Gilet, Milana Flusberg
Seminars in Ultrasound, CT and MRI.2020; 41(2): 139. CrossRef - DUPLICATE: Imaging and Management of Pancreatic Cancer
Mariya Kobi, Gregory Veillette, Roshni Narurkar, David Sadowsky, Viktoriya Paroder, Chaitanya Shilagani, Anthony Gilet, Milana Flusberg
Seminars in Ultrasound, CT and MRI.2019;[Epub] CrossRef
- Pancreatic ductal adenocarcinoma: the latest on diagnosis, molecular profiling, and systemic treatments
- 10,978 View
- 319 Download
- 18 Web of Science
- 17 Crossref
- Magnetic Resonance Imaging for Colorectal Cancer Metastasis to the Liver: Comparative Effectiveness Research for the Choice of Contrast Agents
- Nieun Seo, Mi-Suk Park, Kyunghwa Han, Kyung Ho Lee, Seong Ho Park, Gi Hong Choi, Jin-Young Choi, Yong Eun Chung, Myeong-Jin Kim
- Cancer Res Treat. 2018;50(1):60-70. Published online March 14, 2017
- DOI: https://doi.org/10.4143/crt.2016.533
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Abstract
PDFPubReaderePub
- Purpose
This study was conducted to compare the diagnostic performance and early recurrence rate between gadoxetic acid–enhanced magnetic resonance imaging (Gd-EOB-MRI) and magnetic resonance imaging (MRI) with extracellular contrast agent (ECA-MRI) for evaluating hepatic lesions in colorectal cancer.
Materials and Methods
Between 2005 and 2010, 418 colorectal cancer patients with both preoperative computed tomography (CT) and liver MRI were retrospectively reviewed. Image analysis was based on initial radiologic reports, and diagnostic performance was assessed based on the area under the receiver operating characteristic curve (AUROC). The early intrahepatic recurrence rate within 6 months was then evaluated.
Results
Overall, 291 and 127 patients underwent Gd-EOB-MRI and ECA-MRI, respectively. The AUROCs were not significantly different between Gd-EOB-MRI (0.990; 95% CI, 0.980 to 0.999) and ECA-MRI (0.985; 95% CI, 0.968 to 1.000; p=0.836). When compared with CT alone, ECA-MRI detected additional 21 lesions in 14 patients (14/127, 11.0%), whereas Gd-EOB-MRI detected 56 lesions in 33 patients (33/291, 11.3%) without a significant difference between two MRI groups (p=0.331). The early recurrence rate in the ECA-MRI (28.6%) was significantly higher than that in the Gd-EOB-MRI (11.6%) for patients who underwent hepatic resection (p=0.031).
Conclusion
Gd-EOB-MRI is potentially better than ECA-MRI for decreasing the early intrahepatic recurrence rate, although the two MRI modalities showed comparable diagnostic performance in colorectal cancer patients. -
Citations
Citations to this article as recorded by- Clinical performance of a simulated abbreviated liver magnetic resonance imaging in combination with contrast-enhanced computed tomography for the baseline evaluation of the liver in patients with colorectal cancer
F. Castagnoli, S.J. Withey, M. Konidari, I. Chau, A. Riddell, J. Shur, C. Messiou, D.M. Koh
Clinical Radiology.2025; 80: 106743. CrossRef - Collaborative multi-feature extraction and scale-aware semantic information mining for medical image segmentation
Ruijun Zhang, Zixuan He, Jian Zhu, Xiaochen Yuan, Guoheng Huang, Chi-Man Pun, Jianhong Peng, Junzhong Lin, Jian Zhou
Physics in Medicine & Biology.2022; 67(20): 205008. CrossRef - Diagnostic Performance of Deep Learning-Based Lesion Detection Algorithm in CT for Detecting Hepatic Metastasis from Colorectal Cancer
Kiwook Kim, Sungwon Kim, Kyunghwa Han, Heejin Bae, Jaeseung Shin, Joon Seok Lim
Korean Journal of Radiology.2021; 22(6): 912. CrossRef - Application of intraoperative ultrasound in liver surgery
Ya-Wei Xu, Hong Fu
Hepatobiliary & Pancreatic Diseases International.2021; 20(5): 501. CrossRef - Incremental Role of Pancreatic Magnetic Resonance Imaging after Staging Computed Tomography to Evaluate Patients with Pancreatic Ductal Adenocarcinoma
Hye Jin Kim, Mi-Suk Park, Jin Yong Lee, Kyunghwa Han, Yong Eun Chung, Jin-Young Choi, Myeong-Jin Kim, Chang Moo Kang
Cancer Research and Treatment.2019; 51(1): 24. CrossRef - Abbreviated Gadoxetic Acid–enhanced MRI with Second-Shot Arterial Phase Imaging for Liver Metastasis Evaluation
Jeong Woo Kim, Chang Hee Lee, Yang Shin Park, Jongmee Lee, Kyeong Ah Kim
Radiology: Imaging Cancer.2019; 1(1): e190006. CrossRef - Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?
Serena Langella, Francesco Ardito, Nadia Russolillo, Elena Panettieri, Serena Perotti, Caterina Mele, Felice Giuliante, Alessandro Ferrero
Journal of Oncology.2019; 2019: 1. CrossRef - Capabilities of 18F-FDG PET/CT in the differential diagnosis of colorectal liver metastases
M. S. Tlostanova, A. L. Dolbov, A. A. Stanzhevskii
Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery.2019; 24(4): 18. CrossRef - Imagerie par résonance magnétique dans le bilan local préopératoire des cancers du rectum
M. Djelouah, C. Durot, S. Deguelte-Lardière, J. Cohen, A. Devie, L. Protin-Catteau, C. Hoeffel
EMC - Radiologie et imagerie médicale - Abdominale - Digestive.2019; 37(2): 1. CrossRef
- Clinical performance of a simulated abbreviated liver magnetic resonance imaging in combination with contrast-enhanced computed tomography for the baseline evaluation of the liver in patients with colorectal cancer
- 12,380 View
- 357 Download
- 9 Web of Science
- 9 Crossref
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