Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
Medicine (Baltimore). 2024 May 24;103(21):e38292. doi: 10.1097/MD.0000000000038292.
This study aimed to investigate the prognostic relationship between relative dose intensity (RDI) of adjuvant S-1 chemotherapy and psoas muscle mass volume (PMV) in patients with resected pancreatic ductal adenocarcinoma. We enrolled 105 patients with histologically confirmed pancreatic ductal adenocarcinoma who had undergone pancreatectomy. Adjuvant S-1 chemotherapy was administered to 72 (68.6%) of the 105 patients and not to the remaining 33 patients. Patients who received adjuvant S-1 chemotherapy were stratified into high- and low-RDI groups by the cutoff value for RDI. Five-year overall survival (OS) and relapse-free survival (RFS) rates were significantly higher in the high- than in the low-RDI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high-PMV group than among patients in the low-PMV group. The RDI was an independent prognostic factor in our study patients. Furthermore, patients who received adjuvant S-1 chemotherapy were stratified into 3 groups: those with both high RDI and high-PMV, Group A; those with either high RDI or high PMV (but not both), Group B; and those with both low RDI and low-PMV, group C. There were statistically significant differences in 5-year OS and RFS between 3 patient groups (5-year overall survival: P = .023, 5-year relapse-free survival: P = .001). The area under the curve for the combination of RDI and PMV (0.674) was greater than that for RDI alone (0.645). A sufficient dosage of adjuvant S-1 chemotherapy is important in improving survival of patients with resected pancreatic ductal adenocarcinoma. A combination of RDI and PMV may predict the prognosis of patients with resected pancreatic ductal adenocarcinoma more effective than RDI alone.
本研究旨在探讨辅助 S-1 化疗的相对剂量强度(RDI)与接受胰腺切除术的胰腺导管腺癌患者的腰大肌肌肉量(PMV)之间的预后关系。我们纳入了 105 例经组织学证实的胰腺导管腺癌患者,这些患者均接受了胰腺切除术。72 例(68.6%)患者接受了辅助 S-1 化疗,其余 33 例患者未接受。根据 RDI 的截断值,接受辅助 S-1 化疗的患者被分为高 RDI 组和低 RDI 组。高 RDI 组的 5 年总生存率(OS)和无复发生存率(RFS)明显高于低 RDI 组。同样,高 PMV 组患者的 5 年 OS 和 RFS 率均明显高于低 PMV 组患者。在我们的研究患者中,RDI 是独立的预后因素。此外,我们将接受辅助 S-1 化疗的患者分为 3 组:RDI 和 PMV 均高的患者,A 组;RDI 或 PMV 高(但不是两者)的患者,B 组;RDI 和 PMV 均低的患者,C 组。3 组患者的 5 年 OS 和 RFS 存在统计学差异(5 年总生存率:P=0.023,5 年无复发生存率:P=0.001)。RDI 和 PMV 联合的曲线下面积(AUC)大于 RDI 单独的 AUC(0.674 比 0.645)。辅助 S-1 化疗的足够剂量对于改善接受胰腺切除术的胰腺导管腺癌患者的生存非常重要。RDI 和 PMV 的联合可能比 RDI 单独更有效地预测接受胰腺切除术的胰腺导管腺癌患者的预后。