{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:49:34Z","timestamp":1789663774068,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,4,24]],"date-time":"2014-04-24T00:00:00Z","timestamp":1398297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to identify the predicting factors for unresectability and to clarify who should receive precise evaluations for distant metastasis and locally advanced unresectability in patients with pancreatic ductal adenocarcinoma (<jats:styled-content style=\"fixed-case\">PDAC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 200 consecutive patients with <jats:styled-content style=\"fixed-case\">PDAC<\/jats:styled-content> who presented to the outpatient clinic between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une 2009 and <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ctober 2012 were analyzed retrospectively. Clinical factors and the serum levels of carcinoembryonic antigen (<jats:styled-content style=\"fixed-case\">CEA<\/jats:styled-content>), carbohydrate antigen (<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>) 19\u20109, <jats:styled-content style=\"fixed-case\">DUPAN<\/jats:styled-content>\u20102 (pancreatic cancer\u2010associated antigen) and <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> 125 were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 200 patients who were investigated for <jats:styled-content style=\"fixed-case\">PDAC<\/jats:styled-content>, 60 (30%) were initially considered unresectable (15 patients with locally advanced tumors, 45 patients with distant metastases). Of the 136 (68%) patients who were surgically explored, 19 (9.5%) were detected to have minute metastases on laparotomy. A multivariate analysis revealed that tumor size (\u226530\u2009mm) and abnormalities in the levels of <jats:styled-content style=\"fixed-case\">DUPAN<\/jats:styled-content>\u20102 and <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> 125 were independent predictors of unresectability (<jats:italic>P<\/jats:italic> = 0.002, 0.014, &lt; 0.001, respectively). The patients with triple positive findings presented with the highest sensitivity (78.8%) for unresectability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with triple positive findings for a tumor size \u226530\u2009mm, abnormalities in the levels of <jats:styled-content style=\"fixed-case\">DUPAN<\/jats:styled-content>\u20102 and <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> 125 should receive precise evaluations for unresectability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.109","type":"journal-article","created":{"date-parts":[[2014,4,25]],"date-time":"2014-04-25T00:52:49Z","timestamp":1398387169000},"page":"648-653","source":"Crossref","is-referenced-by-count":21,"title":["Predicting factors for unresectability in patients with pancreatic ductal adenocarcinoma"],"prefix":"10.1002","volume":"21","author":[{"given":"Ken\u2010ichi","family":"Okada","sequence":"first","affiliation":[{"name":"Second Department of Surgery 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