Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer

Nana Kimura; Suguru Yamada; Hideki Takami; Kenta Murotani; Isaku Yoshioka; Kazuto Shibuya; Fuminori Sonohara; Yui Hoshino; Katsuhisa Hirano; Toru Watanabe; Hayato Baba; Kosuke Mori; Takeshi Miwa; Mitsuro Kanda; Masamichi Hayashi; Koshi Matsui; Tomoyuki Okumura; Yasuhiro Kodera; Tsutomu Fujii

doi:10.3390/cancers13010036

Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer

Nana Kimura, Suguru Yamada, Hideki Takami, Kenta Murotani, Isaku Yoshioka, Kazuto Shibuya, Fuminori Sonohara, Yui Hoshino, Katsuhisa Hirano, Toru Watanabe, Hayato Baba, Kosuke Mori, Takeshi Miwa, Mitsuro Kanda, Masamichi Hayashi, Koshi Matsui, Tomoyuki Okumura, Yasuhiro Kodera, Tsutomu Fujii^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background: The objective of this study was to investigate the optimal neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer invading the portal vein (BR-PV) or abutting major arteries (BR-A). Methods: We retrospectively analyzed 88 patients with BR-PV and 111 patients with BR-A. Results: In BR-PV patients who underwent upfront surgery (n = 46)/NAT (n = 42), survival was significantly better in the NAT group (3-year overall survival (OS): 5.8%/35.5%, p = 0.004). In BR-A patients who underwent upfront surgery (n = 48)/NAT (n = 63), survival was also significantly better in the NAT group (3-year OS:15.5%/41.7%, p < 0.001). The prognosis tended to be better in patients who received newer chemotherapeutic regimens, such as FOLFIRINOX and gemcitabine with nab-paclitaxel. In 36 BR-PV patients who underwent surgery after NAT, univariate analysis revealed that normalization of tumor marker (TM) levels (p = 0.028) and preoperative high prognostic nutritional index (PNI) (p = 0.022) were significantly associated with a favorable prognosis. In 39 BR-A patients who underwent surgery after NAT, multivariate analysis revealed that preoperative PNI > 42.5 was an independent prognostic factor (HR: 0.15, p = 0.014). Conclusions: NAT using newer chemotherapy is essential for improving the prognosis of BR pancreatic cancer. These findings suggest that prognosis may be prolonged by maintaining good nutritional status during preoperative treatment.

Original language	English
Article number	36
Pages (from-to)	1-16
Number of pages	16
Journal	Cancers
Volume	13
Issue number	1
DOIs	https://doi.org/10.3390/cancers13010036
State	Published - 2021/01

Keywords

Borderline resectable
Chemoradiotherapy
Neoadjuvant treatment
Pancreatic cancer
Prognostic nutritional index

ASJC Scopus subject areas

Oncology
Cancer Research

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10.3390/cancers13010036

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Kimura, N., Yamada, S., Takami, H., Murotani, K., Yoshioka, I., Shibuya, K., Sonohara, F., Hoshino, Y., Hirano, K., Watanabe, T., Baba, H., Mori, K., Miwa, T., Kanda, M., Hayashi, M., Matsui, K., Okumura, T., Kodera, Y., & Fujii, T. (2021). Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer. Cancers, 13(1), 1-16. Article 36. https://doi.org/10.3390/cancers13010036

@article{61d171f1cafc4936b5f30ca0088f8513,

title = "Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer",

abstract = "Background: The objective of this study was to investigate the optimal neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer invading the portal vein (BR-PV) or abutting major arteries (BR-A). Methods: We retrospectively analyzed 88 patients with BR-PV and 111 patients with BR-A. Results: In BR-PV patients who underwent upfront surgery (n = 46)/NAT (n = 42), survival was significantly better in the NAT group (3-year overall survival (OS): 5.8%/35.5%, p = 0.004). In BR-A patients who underwent upfront surgery (n = 48)/NAT (n = 63), survival was also significantly better in the NAT group (3-year OS:15.5%/41.7%, p < 0.001). The prognosis tended to be better in patients who received newer chemotherapeutic regimens, such as FOLFIRINOX and gemcitabine with nab-paclitaxel. In 36 BR-PV patients who underwent surgery after NAT, univariate analysis revealed that normalization of tumor marker (TM) levels (p = 0.028) and preoperative high prognostic nutritional index (PNI) (p = 0.022) were significantly associated with a favorable prognosis. In 39 BR-A patients who underwent surgery after NAT, multivariate analysis revealed that preoperative PNI > 42.5 was an independent prognostic factor (HR: 0.15, p = 0.014). Conclusions: NAT using newer chemotherapy is essential for improving the prognosis of BR pancreatic cancer. These findings suggest that prognosis may be prolonged by maintaining good nutritional status during preoperative treatment.",

keywords = "Borderline resectable, Chemoradiotherapy, Neoadjuvant treatment, Pancreatic cancer, Prognostic nutritional index",

author = "Nana Kimura and Suguru Yamada and Hideki Takami and Kenta Murotani and Isaku Yoshioka and Kazuto Shibuya and Fuminori Sonohara and Yui Hoshino and Katsuhisa Hirano and Toru Watanabe and Hayato Baba and Kosuke Mori and Takeshi Miwa and Mitsuro Kanda and Masamichi Hayashi and Koshi Matsui and Tomoyuki Okumura and Yasuhiro Kodera and Tsutomu Fujii",

note = "Publisher Copyright: {\textcopyright} 2020 by the authors. Li-censee MDPI, Basel, Switzerland.",

year = "2021",

month = jan,

doi = "10.3390/cancers13010036",

language = "英語",

volume = "13",

pages = "1--16",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "1",

}

Kimura, N, Yamada, S, Takami, H, Murotani, K, Yoshioka, I , Shibuya, K, Sonohara, F, Hoshino, Y, Hirano, K, Watanabe, T, Baba, H, Mori, K, Miwa, T, Kanda, M, Hayashi, M, Matsui, K , Okumura, T, Kodera, Y & Fujii, T 2021, 'Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer', Cancers, vol. 13, no. 1, 36, pp. 1-16. https://doi.org/10.3390/cancers13010036

TY - JOUR

T1 - Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer

AU - Kimura, Nana

AU - Yamada, Suguru

AU - Takami, Hideki

AU - Murotani, Kenta

AU - Yoshioka, Isaku

AU - Shibuya, Kazuto

AU - Sonohara, Fuminori

AU - Hoshino, Yui

AU - Hirano, Katsuhisa

AU - Watanabe, Toru

AU - Baba, Hayato

AU - Mori, Kosuke

AU - Miwa, Takeshi

AU - Kanda, Mitsuro

AU - Hayashi, Masamichi

AU - Matsui, Koshi

AU - Okumura, Tomoyuki

AU - Kodera, Yasuhiro

AU - Fujii, Tsutomu

PY - 2021/1

Y1 - 2021/1

N2 - Background: The objective of this study was to investigate the optimal neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer invading the portal vein (BR-PV) or abutting major arteries (BR-A). Methods: We retrospectively analyzed 88 patients with BR-PV and 111 patients with BR-A. Results: In BR-PV patients who underwent upfront surgery (n = 46)/NAT (n = 42), survival was significantly better in the NAT group (3-year overall survival (OS): 5.8%/35.5%, p = 0.004). In BR-A patients who underwent upfront surgery (n = 48)/NAT (n = 63), survival was also significantly better in the NAT group (3-year OS:15.5%/41.7%, p < 0.001). The prognosis tended to be better in patients who received newer chemotherapeutic regimens, such as FOLFIRINOX and gemcitabine with nab-paclitaxel. In 36 BR-PV patients who underwent surgery after NAT, univariate analysis revealed that normalization of tumor marker (TM) levels (p = 0.028) and preoperative high prognostic nutritional index (PNI) (p = 0.022) were significantly associated with a favorable prognosis. In 39 BR-A patients who underwent surgery after NAT, multivariate analysis revealed that preoperative PNI > 42.5 was an independent prognostic factor (HR: 0.15, p = 0.014). Conclusions: NAT using newer chemotherapy is essential for improving the prognosis of BR pancreatic cancer. These findings suggest that prognosis may be prolonged by maintaining good nutritional status during preoperative treatment.

AB - Background: The objective of this study was to investigate the optimal neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer invading the portal vein (BR-PV) or abutting major arteries (BR-A). Methods: We retrospectively analyzed 88 patients with BR-PV and 111 patients with BR-A. Results: In BR-PV patients who underwent upfront surgery (n = 46)/NAT (n = 42), survival was significantly better in the NAT group (3-year overall survival (OS): 5.8%/35.5%, p = 0.004). In BR-A patients who underwent upfront surgery (n = 48)/NAT (n = 63), survival was also significantly better in the NAT group (3-year OS:15.5%/41.7%, p < 0.001). The prognosis tended to be better in patients who received newer chemotherapeutic regimens, such as FOLFIRINOX and gemcitabine with nab-paclitaxel. In 36 BR-PV patients who underwent surgery after NAT, univariate analysis revealed that normalization of tumor marker (TM) levels (p = 0.028) and preoperative high prognostic nutritional index (PNI) (p = 0.022) were significantly associated with a favorable prognosis. In 39 BR-A patients who underwent surgery after NAT, multivariate analysis revealed that preoperative PNI > 42.5 was an independent prognostic factor (HR: 0.15, p = 0.014). Conclusions: NAT using newer chemotherapy is essential for improving the prognosis of BR pancreatic cancer. These findings suggest that prognosis may be prolonged by maintaining good nutritional status during preoperative treatment.

KW - Borderline resectable

KW - Chemoradiotherapy

KW - Neoadjuvant treatment

KW - Pancreatic cancer

KW - Prognostic nutritional index

UR - http://www.scopus.com/inward/record.url?scp=85098747554&partnerID=8YFLogxK

U2 - 10.3390/cancers13010036

DO - 10.3390/cancers13010036

M3 - 学術論文

C2 - 33374369

AN - SCOPUS:85098747554

SN - 2072-6694

VL - 13

SP - 1

EP - 16

JO - Cancers

JF - Cancers

IS - 1

M1 - 36

ER -

Optimal preoperative multidisciplinary treatment in borderline resectable pancreatic cancer

Abstract

Keywords

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