Hirashita Teijiro, Tada Kazuhiro, Nagasawa Yuiko, Orimoto Hiroki, Kawamura Masahiro, Fujinaga Atsuro, Takayama Hiroomi, Kawano Yoko, Masuda Takashi, Endo Yuichi, Inomata Masafumi
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan.
Mol Clin Oncol. 2024 Dec 12;22(2):18. doi: 10.3892/mco.2024.2813. eCollection 2025 Feb.
Currently, neoadjuvant chemotherapy (NAC) is usually performed even for resectable pancreatic ductal adenocarcinoma (rPDAC). The present study investigated the benefits of NAC with gemcitabine plus S-1 for rPDAC. The medical records of 170 patients diagnosed as having rPDAC based on preoperative imaging were reviewed retrospectively. Clinicopathological factors in the NAC group were compared with those in the upfront surgery (UpS) group. NAC was administered to 30 of the 170 patients. The period from first visit to treatment in the NAC group was shorter than that in the UpS group (P<0.001). Staging laparoscopy detected occult distant metastases in 12 of the 170 patients (7%), of whom all 12 were in the UpS group. All patients in the NAC group underwent surgical resection (P=0.028). Among the 158 patients who underwent pancreatectomy, the NAC group showed rapid induction of the treatment, non-inferior operative outcomes and a higher R0 rate compared with the UpS group. Rates of early recurrence (within 6 months) after surgery were 10% (3/30) in the NAC group and 29% (37/128) in the UpS group (P=0.021). NAC for rPDAC is beneficial in terms of rapid induction of the treatment, fewer occult metastases, and lower rate of early recurrence.
目前，即使对于可切除的胰腺导管腺癌（rPDAC），新辅助化疗（NAC）也通常会进行。本研究调查了吉西他滨联合S-1的NAC方案对rPDAC的疗效。回顾性分析了170例根据术前影像学诊断为rPDAC患者的病历。将NAC组的临床病理因素与直接手术（UpS）组进行比较。170例患者中有30例接受了NAC治疗。NAC组从首次就诊到开始治疗的时间短于UpS组（P<0.001）。分期腹腔镜检查在170例患者中发现了12例隐匿性远处转移（7%），这12例均在UpS组。NAC组所有患者均接受了手术切除（P=0.028）。在158例行胰腺切除术的患者中，与UpS组相比，NAC组治疗诱导迅速，手术效果不差，R0切除率更高。术后早期复发（6个月内）率在NAC组为10%（3/30），在UpS组为29%（37/128）（P=0.021）。对于rPDAC，NAC在治疗诱导迅速、隐匿性转移较少以及早期复发率较低方面是有益的。
