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Research ArticleClinical Studies

Elevated Preoperative DUPAN-2 Level Predicts Locoregional Recurrence After Pancreatectomy in Patients With Pancreatic Ductal Adenocarcinoma

ATSUSHI SASAKI, SHOICHI INOKUCHI, SATOSHI TSUTSUMI, TAKURO FUTSUKAICHI, TAKAHIRO TERASHI, MASAHIKO IKEBE, TOSHIO BANDOH and TOHRU UTSUNOMIYA
Anticancer Research April 2022, 42 (4) 2071-2078; DOI: https://doi.org/10.21873/anticanres.15688
ATSUSHI SASAKI
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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  • For correspondence: sasakia@oita-u.ac.jp
SHOICHI INOKUCHI
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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SATOSHI TSUTSUMI
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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TAKURO FUTSUKAICHI
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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TAKAHIRO TERASHI
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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MASAHIKO IKEBE
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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TOSHIO BANDOH
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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TOHRU UTSUNOMIYA
Department of Surgery, Oita Prefectural Hospital, Oita, Japan
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Abstract

Background/Aim: The diagnostic value of serum DUPAN-2 level has been reported; however, the relationship between preoperative DUPAN-2 level and recurrence pattern has not been fully investigated in pancreatic ductal adenocarcinoma (PDAC). Patients and Methods: We retrospectively analyzed 50 patients with PDAC who underwent pancreatectomy. The relationships between clinicopathologic factors and site-specific disease-free survival (DFS) were analyzed using Cox proportional hazard and receiver operating characteristic (ROC) curve analyses. Results: The tumor location was the pancreatic head in 31 patients and the body/tail in 19 patients. Of the 50 patients, 34 had recurrence (median DFS, 11 months). Fifteen patients had hematogenous recurrence, and 16 had locoregional recurrence. In multivariate analysis, adjuvant chemotherapy [p=0.01; odds ratio (OR)=8.10; 95% confidence interval (CI)=1.58-41.6] and venous invasion (p=0.01; OR=8.33; 95%CI=1.53-45.4) were significant factors for hematogenous recurrence-free survival, whereas the neutrophil-to-lymphocyte ratio (p=0.03; OR=2.57; 95%CI=1.10-5.98) and DUPAN-2 level (p<0.01; OR=1.00; 95%CI=1.000-1.002) were significant factors for locoregional recurrence-free survival. In ROC curve analysis, the area under the curve of DUPAN-2 level was 0.613 for hematogenous recurrence and 0.682 for locoregional recurrence. In the log-rank test, the hematogenous and locoregional recurrence-free survival rates of patients with higher DUPAN-2 levels were significantly worse than those with lower DUPAN-2 level. Conclusion: Elevation of preoperative DUPAN-2 level independently predicts locoregional recurrence after surgery. Patients with elevated preoperative DUPAN-2 level may benefit from neoadjuvant chemoradiation therapy to avoid postoperative locoregional recurrence.

Key Words:
  • DUPAN-2
  • pancreatic cancer
  • recurrence pattern
  • locoregional recurrence
  • pancreatectomy
  • Received February 18, 2022.
  • Revision received March 3, 2022.
  • Accepted March 4, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (4)
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April 2022
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Elevated Preoperative DUPAN-2 Level Predicts Locoregional Recurrence After Pancreatectomy in Patients With Pancreatic Ductal Adenocarcinoma
ATSUSHI SASAKI, SHOICHI INOKUCHI, SATOSHI TSUTSUMI, TAKURO FUTSUKAICHI, TAKAHIRO TERASHI, MASAHIKO IKEBE, TOSHIO BANDOH, TOHRU UTSUNOMIYA
Anticancer Research Apr 2022, 42 (4) 2071-2078; DOI: 10.21873/anticanres.15688

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Elevated Preoperative DUPAN-2 Level Predicts Locoregional Recurrence After Pancreatectomy in Patients With Pancreatic Ductal Adenocarcinoma
ATSUSHI SASAKI, SHOICHI INOKUCHI, SATOSHI TSUTSUMI, TAKURO FUTSUKAICHI, TAKAHIRO TERASHI, MASAHIKO IKEBE, TOSHIO BANDOH, TOHRU UTSUNOMIYA
Anticancer Research Apr 2022, 42 (4) 2071-2078; DOI: 10.21873/anticanres.15688
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Keywords

  • DUPAN-2
  • pancreatic cancer
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