Prognostic Significance of Post-Neoadjuvant Chemotherapy Carbohydrate Antigen 19-9 Levels in Patients With Resectable Pancreatic Cancer Treated With S-1 and Gemcitabine: A Retrospective Cohort Study.

IF 2.2 Q3 ONCOLOGY

World Journal of Oncology Pub Date : 2025-06-01 Epub Date: 2025-06-14 DOI:10.14740/wjon2563

Yuki Homma, Kentaro Miyake, Yutaro Kikuchi, Yasuhiro Yabushita, Ryusei Matsuyama, Itaru Endo

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引用次数: 0

Abstract

Background: Carbohydrate antigen 19-9 (CA19-9) is widely used to assess treatment response and monitor recurrence alongside imaging. However, the criteria for determining resectability after completion of neoadjuvant therapy (NAT) remain poorly defined. Therefore, this study aimed to investigate the indications for surgical resection as a prognostic factor following NAT with gemcitabine and S-1 (NATGS).

Methods: In this retrospective cohort study, we examined patients who underwent curative pancreatic resection following NATGS at our institution between April 2018 and December 2023. After excluding six patients who did not undergo pancreatectomy, the remaining 50 patients were included in the study. Univariate and multivariate analyses were conducted to identify factors potentially associated with survival after NATGS.

Results: Post-NATGS CA19-9 levels (< 100 U/mL) were identified as a significant prognostic factor for disease-free survival (DFS) in both univariate and multivariate analyses (hazard ratio (HR) = 11.72251, P < 0.001). For overall survival (OS), both CA19-9 levels (< 100 U/mL) and Duke pancreatic monoclonal antigen type 2 (DUPAN-2) levels (< 150 U/mL) were significant prognostic factors in univariate and multivariate analyses (CA19-9: HR = 17.88, P = 0.002; DUPAN-2: HR = 2.667, P = 0.03). The median DFS was 24.1 months in the low CA19-9 group compared with the 7.1 months in the high CA19-9 group (P = 0.002). The median OS in the low CA19-9 group was not reached, whereas it was 14.7 months in the high CA19-9 group (P = 0.001).

Conclusions: The CA19-9 cut-off value is clinically significant for patients undergoing NATGS regimens. Patients with pre-operative CA19-9 levels ≥ 100 U/mL may benefit from extended GS treatment or a switch to a more potent regimen rather than proceeding directly to surgical resection.

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S-1联合吉西他滨治疗可切除胰腺癌患者新辅助化疗后碳水化合物抗原19-9水平的预后意义：一项回顾性队列研究

背景：碳水化合物抗原19-9 （CA19-9）被广泛用于评估治疗反应和监测复发以及影像学检查。然而，确定完成新辅助治疗（NAT）后可切除性的标准仍然不明确。因此，本研究旨在探讨手术切除指征作为吉西他滨和S-1 （NATGS）合并NAT后的预后因素。方法：在这项回顾性队列研究中，我们调查了2018年4月至2023年12月期间在我院接受NATGS术后根治性胰腺切除术的患者。在排除了6名未行胰腺切除术的患者后，剩余的50名患者被纳入研究。进行了单因素和多因素分析，以确定与NATGS后生存相关的潜在因素。结果：natgs后CA19-9水平（< 100 U/mL）在单因素和多因素分析中均被确定为无病生存（DFS）的重要预后因素（风险比(HR) = 11.72251, P < 0.001）。对于总生存率（OS），单因素和多因素分析中，CA19-9水平（< 100 U/mL）和杜克胰腺单克隆抗原2 （DUPAN-2）水平（< 150 U/mL）是显著的预后因素(CA19-9: HR = 17.88, P = 0.002；Dupan-2: hr = 2.667, p = 0.03)。低CA19-9组的中位DFS为24.1个月，而高CA19-9组为7.1个月（P = 0.002）。低CA19-9组的中位OS未达到，而高CA19-9组的中位OS为14.7个月（P = 0.001）。结论：CA19-9临界值对于接受NATGS方案的患者具有临床意义。术前CA19-9水平≥100 U/mL的患者可能受益于延长GS治疗或切换到更有效的方案，而不是直接进行手术切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Oncology ONCOLOGY-

CiteScore

6.10

自引率

15.40%

发文量

期刊介绍： World Journal of Oncology, bimonthly, publishes original contributions describing basic research and clinical investigation of cancer, on the cellular, molecular, prevention, diagnosis, therapy and prognosis aspects. The submissions can be basic research or clinical investigation oriented. This journal welcomes those submissions focused on the clinical trials of new treatment modalities for cancer, and those submissions focused on molecular or cellular research of the oncology pathogenesis. Case reports submitted for consideration of publication should explore either a novel genomic event/description or a new safety signal from an oncolytic agent. The areas of interested manuscripts are these disciplines: tumor immunology and immunotherapy; cancer molecular pharmacology and chemotherapy; drug sensitivity and resistance; cancer epidemiology; clinical trials; cancer pathology; radiobiology and radiation oncology; solid tumor oncology; hematological malignancies; surgical oncology; pediatric oncology; molecular oncology and cancer genes; gene therapy; cancer endocrinology; cancer metastasis; prevention and diagnosis of cancer; other cancer related subjects. The types of manuscripts accepted are original article, review, editorial, short communication, case report, letter to the editor, book review.