Tezuka Koji, Okamura Yukiyasu, Sugiura Teiichi, Ito Takaaki, Yamamoto Yusuke, Ashida Ryo, Ohgi Katsuhisa, Otsuka Shimpei, Todaka Akiko, Fukutomi Akira, Uesaka Katsuhiko
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Pancreatology. 2021 Dec;21(8):1451-1459. doi: 10.1016/j.pan.2021.08.009. Epub 2021 Aug 24.
BACKGROUND/OBJECTIVES: This study aimed to develop the prognostic score (PS) based on clinical factors to stratify the prognosis in borderline resectable pancreatic cancer (BRPC) patients treated with neoadjuvant therapy (NAT).
This retrospective study included 57 BRPC patients who received NAT between April 2012 and December 2017. A score was assigned to each prognostic factor available before and after NAT, according to their β coefficients.
Multivariate analysis identified the following six prognostic factors, and scores were assigned as follows: being a familial PC patient (HR 4.98, p = 0.029), post-NAT CA19-9 ≥37 U/ml (HR 3.08, p = 0.020), reduction rate of CA19-9 <70% (HR 3.71, p = 0.008), pre-NAT neutrophil-to-lymphocyte ratio ≥2.8 (HR 4.32, p = 0.003), and non-resection (HR 3.98, p = 0.009) were scored as 1; and post-NAT albumin-to-globulin ratio <1.33 (HR 8.31, p < 0.001) was scored as 2. The PS was calculated by summing the scores assigned to each prognostic factor. Patients were then classified into three risk groups (low- [0-1 points], moderate- [2-3 points], and high-risk [4-6 points] groups). Median overall survival in the low-, moderate-, and high-risk groups were not reached, 37.5 months, and 11.8 months, respectively, and there were significant differences in survival among the three groups (p < 0.01 in each group).
This study showed that the PS may be useful for predicting the prognosis of BRPC patients treated with NAT.
背景/目的：本研究旨在基于临床因素制定预后评分（PS），以对接受新辅助治疗（NAT）的临界可切除胰腺癌（BRPC）患者的预后进行分层。
这项回顾性研究纳入了2012年4月至2017年12月期间接受NAT的57例BRPC患者。根据每个预后因素的β系数，为NAT前后可用的每个预后因素分配一个分数。
多因素分析确定了以下六个预后因素，并按以下方式分配分数：为家族性胰腺癌患者（HR 4.98，p = 0.029）、NAT后CA19-9≥37 U/ml（HR 3.08，p = 0.020）、CA19-9降低率<70%（HR 3.71，p = 0.008）、NAT前中性粒细胞与淋巴细胞比值≥2.8（HR 4.32，p = 0.003）以及未切除（HR 3.98，p = 0.009）得1分；NAT后白蛋白与球蛋白比值<1.33（HR 8.31，p < 0.001）得2分。PS通过将分配给每个预后因素的分数相加来计算。然后将患者分为三个风险组（低风险组[0 - 1分]、中风险组[2 - 3分]和高风险组[4 - 6分]）。低风险组、中风险组和高风险组的中位总生存期分别未达到、37.5个月和11.8个月，三组之间的生存期存在显著差异（每组p < 0.01）。
本研究表明，PS可能有助于预测接受NAT的BRPC患者的预后。
