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*

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

12 被引用数 (Scopus)

抄録

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.

本文言語英語
論文番号36
ページ(範囲)1-16
ページ数16
ジャーナルCancers
13
1
DOI
出版ステータス出版済み - 2021/01

ASJC Scopus 主題領域

  • 腫瘍学
  • 癌研究

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