Evidence map›Paper›PMID 42507022›Full record

ArticleSurgery today2026

Symptom presentation at diagnosis as a biological risk indicator in both resectable and unresectable pancreatic ductal adenocarcinoma.

Takahiro Tomino, Keishi Sugimachi, Lingaku Lee, Takeshi Kurihara, Emi Onishi, Yusuke Niina, Terumasa Hisano, Rie Sugimoto, Naomichi Koga, Yuta Kasagi and 3 more

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Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Takahiro TominoDepartment of Hepatobiliary and Pancreatic Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Keishi SugimachiDepartment of Hepatobiliary and Pancreatic Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan. ksugimachi@gmail.com.
Lingaku LeeDepartment of Hepato-Biliary-Pancreatology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Takeshi KuriharaDepartment of Hepatobiliary and Pancreatic Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Emi OnishiDepartment of Hepatobiliary and Pancreatic Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Yusuke NiinaDepartment of Hepato-Biliary-Pancreatology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Terumasa HisanoDepartment of Hepato-Biliary-Pancreatology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Rie SugimotoDepartment of Hepato-Biliary-Pancreatology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Naomichi KogaDepartment of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.
Yuta KasagiDepartment of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.
Masahiko SugiyamaDepartment of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.
Yasue KimuraDepartment of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.
Masaru MoritaDepartment of Gastroenterological Surgery, NHO Kyushu Cancer Center, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSymptom presentation at diagnosis is considered a surrogate marker of disease stage in pancreatic ductal adenocarcinoma (PDAC). However, its prognostic impact across resectability stages remains unclear. We evaluated whether symptoms serve as biological risk indicators using stratified analyses of surgical and non-surgical cohorts.

methodsThis retrospective single-center study included 729 patients with PDAC: non-resected (n = 519) and resected (n = 210), including 179 with anatomically resectable disease. Patients were classified as asymptomatic or symptomatic at the time of diagnosis. Overall survival (OS) was compared, and preoperative variables were assessed as independent predictors of OS.

resultsSymptomatic patients had a significantly worse overall survival (OS) across cohorts. In the non-resected cohort, the 3-year OS was 1.8% in symptomatic patients vs. 10.3% in asymptomatic patients (p < 0.001). In the resected cohort, the 5-year OS was 27.6% vs. 38.7% (p = 0.024). In the resectable cohort, the 5-year OS was 22.5% vs. 38.3% (p < 0.001). Symptom presentation independently predicted a poorer OS in multivariable analyses of resected patients (hazard ratio, 1.58; p = 0.024) and those with anatomically resectable disease (hazard ratio, 1.83; p = 0.015).

conclusionsSymptoms at diagnosis were associated with a poorer OS in PDAC, regardless of resectability, suggesting a simple, broadly available marker that may complement anatomical stratification.

Indexed as

Overall survivalPancreatic ductal adenocarcinomaResectabilityRisk stratificationSymptoms

Identifiers

PMID42507022

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