Perioperative Clinical Usage of Phellinus Linteus as a Nutraceutical for Non-FOLFIRINOX-Based Postoperative Adjuvant Chemotherapy for Resected Pancreatic Cancer: A Retrospective Cohort Study.

INTRODUCTION

Most patients with pancreatic cancer experience systemic recurrence within 1 to 2 years after radical pancreatectomy. Phellinus linteus (PL) has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties, suggesting potential as an adjunct to cancer therapy. This study aimed to evaluate the long-term oncological impact of perioperative PL in resected pancreatic cancer.

METHOD

This retrospective cohort study included 407 patients who underwent curative resection and adjuvant chemotherapy for pancreatic cancer at Severance Hospital (2012-2022). Among them, 103 patients who began PL postoperatively and continued throughout treatment were assigned to the PL group; 304 patients without PL intake comprised the control group.

RESULTS

The mean overall survival (OS) was significantly longer in the PL group (47.0 months; 95% CI: 42.8-51.1) than in the control group (35.0 months; 95% CI: 30.3-39.7; < .001). Recurrence-free survival (RFS) showed a borderline improvement ( = .053). PL use was marginally associated with improved OS in multivariate analysis (HR: 0.614; 95% CI: 0.376-1.002; = .051). Subgroup analysis showed no significant OS or RFS benefit with PL in patients receiving FOLFIRINOX. However, among patients treated with non-FOLFIRINOX regimens, PL use led to significantly better OS (43.9 months vs 35.0 months; = .021), though RFS remained similar. Notably, the OS of the non-FOLFIRINOX + PL group was comparable to that of the FOLFIRINOX group ( = .332) and superior to the non-FOLFIRINOX control group ( = .021).

CONCLUSION

PL may enhance survival in resected pancreatic cancer, particularly in patients receiving non-FOLFIRINOX chemotherapy, supporting its role as a potential adjunct when FOLFIRINOX is not feasible.