Background: This study aimed to investigate whether structured surveillance after resection of PDAC has an impact on survival. Methods: 206 patients who underwent PDAC resection at the University Hospital Erlangen between 2005 and 2020 and survived for at least 90 days postoperatively were included in this retrospective study. The impact of surveillance (structured vs. no structured surveillance) respectively of recurrence patterns (recurrence in follow-up vs. symptomatic recurrence) on overall and disease-free survival was investigated. Results: A total of 157 patients (76%) participated in a structured surveillance program after pancreatic resection. During a mean follow-up of 28.5 months, 137 patients (67%) developed recurrence. Patients with structured surveillance showed significantly better outcomes for overall survival after surgery (OSaS: 29.2 months with structured surveillance vs. 16.4 months without,p< 0.001), overall survival after recurrence (OSaR: 10.8 months vs. 3.6 months,p< 0.001), and disease-free survival (DFS: 14.8 months vs. 11.4 months,p= 0.010). In a subgroup analysis of 112 patients with recurrence, survival benefits were observed for those whose recurrence was detected during follow-up compared to those with symptomatic recurrence (OSaS: 24.8 months in the follow-up group vs. 17.2 months in the symptomatic group,p< 0.001; OSaR: 12.6 months vs. 6.5 months,p< 0.001). Conclusion: This study provides evidence that structured surveillance after PDAC resection is beneficial for both overall and disease-free survival. However, randomized studies are needed to confirm the positive impact of structured surveillance programs on survival after pancreatic resection.
背景：本研究旨在探讨胰腺导管腺癌（PDAC）切除术后结构化监测是否对生存期产生影响。方法：本研究回顾性纳入2005年至2020年间在埃尔朗根大学医院接受PDAC切除术且术后存活至少90天的206例患者。分析监测方式（结构化监测 vs. 无结构化监测）及复发模式（随访中发现复发 vs. 出现症状后复发）对总生存期和无病生存期的影响。结果：157例患者（76%）在胰腺切除术后参与了结构化监测项目。在平均28.5个月的随访期间，137例患者（67%）出现复发。接受结构化监测的患者在术后总生存期（OSaS：结构化监测组29.2个月 vs. 非监测组16.4个月，p<0.001）、复发后总生存期（OSaR：10.8个月 vs. 3.6个月，p<0.001）和无病生存期（DFS：14.8个月 vs. 11.4个月，p=0.010）方面均显著更优。在112例复发患者的亚组分析中，随访中发现复发的患者较出现症状后复发的患者生存获益更显著（OSaS：随访组24.8个月 vs. 症状组17.2个月，p<0.001；OSaR：12.6个月 vs. 6.5个月，p<0.001）。结论：本研究证实PDAC切除术后结构化监测有利于改善总生存期和无病生存期。但需通过随机研究进一步验证结构化监测项目对胰腺切除术后生存期的积极影响。
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