A Therapeutic Strategy for Resectable Pancreatic Cancer Based on Risk Factors of Early Recurrence.

OBJECTIVES

The aim of this study was to identify risk factors for early recurrence and assess the prognostic benefit of neoadjuvant therapy (NAT) for resectable pancreatic cancer.

METHODS

Patients with radiographically resectable pancreatic cancer according to the National Comprehensive Cancer Network guidelines were enrolled. We regarded recurrence within 6 months after surgery as early recurrence.

RESULTS

This study involved 115 patients (80 who underwent upfront surgery and 35 who received NAT). Serum carbohydrate antigen 19-9 greater than 85 U/mL and p53 expression in 0 or more than 80% of tumor cells were independent risk factors for early recurrence after upfront surgery. We classified patients into a high-risk group (1 or 2 risk factors) and a low-risk group (no risk factors). In the high-risk group, the median overall survival time of patients with NAT was significantly longer than that of patients without NAT (P = 0.028). By contrast, the median overall survival time was not different according to NAT in the low-risk group.

CONCLUSIONS

Serum carbohydrate antigen 19-9 and p53 expression of the primary tumor could be predictors of early recurrence in patients with resectable pancreatic cancer. The prognosis of patients with a high risk of early recurrence may be improved using NAT.