Kurahara Hiroshi, Maemura Kosei, Mataki Yuko, Sakoda Masahiko, Iino Satoshi, Kawasaki Yota, Arigami Takaaki, Mori Shinichiro, Kijima Yuko, Ueno Shinichi, Shinchi Hiroyuki, Natsugoe Shoji
From the Departments of Digestive Surgery, Breast and Thyroid Surgery.
Clinical Oncology.
Pancreas. 2018 Jul;47(6):753-758. doi: 10.1097/MPA.0000000000001066.
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.
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.
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.
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.
本研究旨在确定早期复发的危险因素，并评估新辅助治疗（NAT）对可切除胰腺癌的预后益处。
纳入根据美国国立综合癌症网络指南影像学检查可切除的胰腺癌患者。我们将术后6个月内的复发视为早期复发。
本研究纳入了115例患者（80例接受 upfront 手术，35例接受NAT）。血清糖类抗原19-9大于85 U/mL以及肿瘤细胞中0或超过80%的细胞有p53表达是 upfront 手术后早期复发的独立危险因素。我们将患者分为高危组（1个或2个危险因素）和低危组（无危险因素）。在高危组中，接受NAT的患者的中位总生存时间显著长于未接受NAT的患者（P = 0.028）。相比之下，低危组中根据是否接受NAT，中位总生存时间无差异。
血清糖类抗原19-9和原发肿瘤的p53表达可能是可切除胰腺癌患者早期复发的预测指标。使用NAT可能改善早期复发高危患者的预后。
