Hiroshi Kurahara1, Yuko Mataki2, Tetsuya Idichi2, Satoshi Iino2, Yota Kawasaki2, Takaaki Arigami2, Shinichiro Mori2, Ken Sasaki2, Hiroyuki Shinchi3, Takao Ohtsuka2. 1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan. h-krhr@m3.kufm.kagoshima-u.ac.jp. 2. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan. 3. Health Sciences, Kagoshima University, Kagoshima, Japan.
Abstract
PURPOSE: Neoadjuvant therapy (NAT) is used to treat not only advanced pancreatic cancer but also resectable lesions. The present study investigated the effectiveness of postoperative adjuvant chemotherapy for patients with pancreatic cancer who underwent surgical resection after NAT. METHODS: Patients who underwent macroscopically curative resection after NAT for pancreatic cancer were enrolled. Adjuvant chemotherapy was defined as at least 1 cycle of planned chemotherapy within 3 months after the date of surgery and included S-1, gemcitabine, or both. We retrospectively examined the effect of adjuvant chemotherapy on overall survival (OS) and recurrence-free survival (RFS) as a function of patients' clinicopathological factors. RESULTS: Ninety-seven patients were included in the study, of which 68 (70.1%) underwent adjuvant chemotherapy. Administration of adjuvant chemotherapy was significantly associated with prolonged OS and RFS in patients whose elevated levels of carbohydrate antigen 19-9 or duke pancreatic monoclonal antigen type-2 did not normalize after NAT. In patients with pathological lymph node metastasis, the administration of adjuvant chemotherapy was significantly associated with longer OS but did not improve PFS. CONCLUSIONS: Postoperative adjuvant chemotherapy was associated with prolonged postoperative survival in patients with pancreatic cancer who did not sufficiently respond to NAT as judged by tumor marker expression.
PURPOSE: Neoadjuvant therapy (NAT) is used to treat not only advanced pancreatic cancer but also resectable lesions. The present study investigated the effectiveness of postoperative adjuvant chemotherapy for patients with pancreatic cancer who underwent surgical resection after NAT. METHODS:Patients who underwent macroscopically curative resection after NAT for pancreatic cancer were enrolled. Adjuvant chemotherapy was defined as at least 1 cycle of planned chemotherapy within 3 months after the date of surgery and included S-1, gemcitabine, or both. We retrospectively examined the effect of adjuvant chemotherapy on overall survival (OS) and recurrence-free survival (RFS) as a function of patients' clinicopathological factors. RESULTS: Ninety-seven patients were included in the study, of which 68 (70.1%) underwent adjuvant chemotherapy. Administration of adjuvant chemotherapy was significantly associated with prolonged OS and RFS in patients whose elevated levels of carbohydrate antigen 19-9 or duke pancreatic monoclonal antigen type-2 did not normalize after NAT. In patients with pathological lymph node metastasis, the administration of adjuvant chemotherapy was significantly associated with longer OS but did not improve PFS. CONCLUSIONS: Postoperative adjuvant chemotherapy was associated with prolonged postoperative survival in patients with pancreatic cancer who did not sufficiently respond to NAT as judged by tumor marker expression.
Authors: Stijn van Roessel; Eran van Veldhuisen; Sjors Klompmaker; Quisette P Janssen; Mohammed Abu Hilal; Adnan Alseidi; Alberto Balduzzi; Gianpaolo Balzano; Claudio Bassi; Frederik Berrevoet; Morgan Bonds; Olivier R Busch; Giovanni Butturini; Marco Del Chiaro; Kevin C Conlon; Massimo Falconi; Isabella Frigerio; Giuseppe K Fusai; Johan Gagnière; Oonagh Griffin; Thilo Hackert; Asif Halimi; Ulla Klaiber; Knut J Labori; Giuseppe Malleo; Marco V Marino; Michael B Mortensen; Andrej Nikov; Mickaël Lesurtel; Tobias Keck; Jörg Kleeff; Rupaly Pandé; Per Pfeiffer; D Pietrasz; Keith J Roberts; Antonio Sa Cunha; Roberto Salvia; Oliver Strobel; Timo Tarvainen; Patrick M Bossuyt; Hanneke W M van Laarhoven; Johanna W Wilmink; Bas Groot Koerkamp; Marc G Besselink Journal: JAMA Oncol Date: 2020-11-01 Impact factor: 31.777