Detailed Abstract
[BP Best Oral Presentation - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP BO-S2] Stage-matched Prognosis Comparison between YpTNM And PTNM Stage in Pancreatic Cancer
Hyeong Seok KIM 1, Hochang CAHE 1, Soo Yeun LIM 1, HyeJeong JEONG 1, So Jeong YOON 1, Sang Hyun SHIN 1, In Woong HAN 1, Jin Seok HEO 1, Hongbeom KIM 1
1 Surgery, Samsung Medical Center, REPUBLIC OF KOREA
Background : The 8th AJCC TNM staging, which introduced ypTNM for NAT patients, has not been comparatively assessed against pTNM for prognosis. This study evaluated the prognoses between ypTNM and pTNM stages in resected pancreatic cancer.
Methods : Total 586 patients who underwent pancreatic cancer surgery at a tertiary center between 2018 and 2022 was analyzed. Clinicopathologic data were analyzed, a propensity score-matched (PSM) analysis was conducted based on factors influencing survival (OS).
Results : The analysis included 541 patients (100 ypTNM, 441 pTNM) after exclusion. Comparable OS was observed between two groups (3-year survival rate (YSR) 68.7% vs 56.3%, p=0.094). Subgroup analysis by stages I (76.8% vs 67.5%, p=0.577), II (56.2% vs 53.0%, p=0.715), and III (26.5% vs 28.7%, p=0.596) revealed similar survival between two groups. Multivariate analysis identified factors such as age >65 (HR 1.651, p=0.002), CA19-9 >150 U/mL (HR 1.476, p=0.010), preoperative biliary drainage (HR 1.372, p=0.048), pathologic T2 stage (HR 2.188, p=0.002) and T3/4 stage (HR 3.178, p<0.001) compared to T0/1 stage, lymphovascular invasion (HR 2.087, p<0.001), and adjuvant treatment (HR 0.243, p<0.001) associated with OS. After PSM analysis, stages I (3YSR 76.8% vs 71.7%, p=0.923), II (56.2% vs 46.6%, p=0.886), and III (26.5% vs 31.4%, p=0.856) exhibited no significant difference between two groups.
Conclusions : This study underscores comparable survival outcomes between ypTNM and pTNM stages in surgically resected pancreatic cancer, affirming the applicability of the TNM staging system after NAT. Consistent survival results, even following PSM analysis, highlight the reliability of TNM staging for guiding therapeutic decisions even in patients with NAT.
Methods : Total 586 patients who underwent pancreatic cancer surgery at a tertiary center between 2018 and 2022 was analyzed. Clinicopathologic data were analyzed, a propensity score-matched (PSM) analysis was conducted based on factors influencing survival (OS).
Results : The analysis included 541 patients (100 ypTNM, 441 pTNM) after exclusion. Comparable OS was observed between two groups (3-year survival rate (YSR) 68.7% vs 56.3%, p=0.094). Subgroup analysis by stages I (76.8% vs 67.5%, p=0.577), II (56.2% vs 53.0%, p=0.715), and III (26.5% vs 28.7%, p=0.596) revealed similar survival between two groups. Multivariate analysis identified factors such as age >65 (HR 1.651, p=0.002), CA19-9 >150 U/mL (HR 1.476, p=0.010), preoperative biliary drainage (HR 1.372, p=0.048), pathologic T2 stage (HR 2.188, p=0.002) and T3/4 stage (HR 3.178, p<0.001) compared to T0/1 stage, lymphovascular invasion (HR 2.087, p<0.001), and adjuvant treatment (HR 0.243, p<0.001) associated with OS. After PSM analysis, stages I (3YSR 76.8% vs 71.7%, p=0.923), II (56.2% vs 46.6%, p=0.886), and III (26.5% vs 31.4%, p=0.856) exhibited no significant difference between two groups.
Conclusions : This study underscores comparable survival outcomes between ypTNM and pTNM stages in surgically resected pancreatic cancer, affirming the applicability of the TNM staging system after NAT. Consistent survival results, even following PSM analysis, highlight the reliability of TNM staging for guiding therapeutic decisions even in patients with NAT.
SESSION
BP Best Oral Presentation
Room A 3/22/2024 1:30 PM - 2:50 PM