Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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A Comparative Study of Survivor Outcomes between Preoperative Evaluation Using CT Alone and Combined CT and MRI in Patients with Pancreatic Ductal Adenocarcinoma

췌장선암 환자의 수술 전 CT 단독 평가와 추가적 MRI 평가에 따른 생존 결과 비교 분석

  • Ji Eun Lee (Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital) ;
  • Seong Hyun Kim (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Soon Jin Lee (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seo-Youn Choi (Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital) ;
  • Sunyoung Lee (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bo Ra Lee (Department of Biomedical Statistics, Soonchunhyang University College of Medicine, Bucheon Hospital)
  • 이지은 (순천향대학교 의과대학 부천병원 영상의학과) ;
  • 김성현 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 이순진 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 최서연 (순천향대학교 의과대학 부천병원 영상의학과) ;
  • 이선영 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 이보라 (순천향대학교 의과대학 부천병원 의학통계학과)
  • Received : 2020.04.22
  • Accepted : 2020.07.04
  • Published : 2021.05.01
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Abstract

Purpose To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

목적 췌장선암으로 완치 수술을 시행 받은 환자들 중 수술 전 CT만 시행 받은 환자군과 추가적 MRI를 시행 받은 환자군의 재발 양상 및 생존율을 비교하고, 첫 재발 위치에 따른 예후 차이를 비교하고자 한다. 대상과 방법 췌장선암으로 R0 수술을 시행 받은 152명의 환자를 대상으로 하였다. 이중 103명은 수술 전 CT만 시행 받았고, 나머지 49명은 추가적 MRI를 시행 받았다. 두 명의 영상의학과 의사가 합의하에 각 환자의 첫 재발 위치와 재발 시기를 평가하였다. 두 환자군의 재발 양상, 무병 생존율, 전체 생존율을 비교하고, 첫 재발 위치에 따른 예후를 비교하였다. 결과 두 환자군 모두 간 전이가 가장 흔한 재발 양상이었고, 무병 생존율(p = 0.247)과 전체 생존율(p = 0.067)은 유의한 차이가 없었다. 첫 재발 위치에 따른 예후는 간 전이가 가장 나빴고, 그다음은 국소 재발이었다(p < 0.001). 결론 췌장선암으로 완치 수술을 시행 받은 환자에서 수술 전 CT만 시행 받은 환자군과 추가적 MRI를 시행 받은 환자군 사이에 재발 양상과 생존율은 유의한 차이가 없었다. 간 전이가 가장 흔한 재발 양상이었고, 다른 재발 양상과 비교하여 예후가 가장 나빴다.

Keywords

Acknowledgement

This work was supported by the Soonchunhyang University Research Fund.

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