Efficacy of Neoadjuvant Therapy for Resectable Pancreatic Cancer Might be Limited to Biologically Borderline Resectable Cases.

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2025-03-03 DOI:10.1097/MPA.0000000000002485

Yoshiyasu Kato, Ryo Ashida, Katsuhisa Ohgi, Shimpei Otsuka, Hideyuki Dei, Katsuhiko Uesaka, Kentaro Yamazaki, Teiichi Sugiura

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引用次数: 0

Abstract

Background: Neoadjuvant therapy (NAT) followed by surgery is becoming standard treatment even for resectable pancreatic cancer (RPC). However, it is unclear whether NAT is necessary for all RPC cases.

Methods: 296 patients diagnosed with RPC and under 80 years old were retrospectively analyzed, focusing on tumor markers (TM). The cutoff value of TM was decided based on the classification by the International Association of Pancreatology.

Results: Among 80 cases who underwent NAT, 72 cases were accomplished surgical resection. Upfront surgery (UpS) was planned in 216 cases, and surgical resection was accomplished in 199 cases. Resection rate showed no difference between the two groups (P=0.638). Although NAT group showed a favorable trend in overall survival (OS) compared to the UpS group, the difference was not significant (P=0.143). CA19-9 >500 U/mL and/or DUPAN2 >700 U/mL was defined as high TM. When comparing in TM-high group (n=83), patients with NAT showed significantly better OS than those without NAT (P=0.024). In TM-low group (n=213), the OS curves completely overlapped with no difference (P=0.902). A multivariate analysis demonstrated that undergoing NAT was the sole independent prognostic factor in the TM-high group (Hazard ratio: 0.48, P=0.044), while undergoing NAT was not a prognostic factor in the TM-low group.

Conclusion: The efficacy of NAT for RPC might be limited to the subset of patients with high TM.

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.