Detailed Abstract
[BP Best Oral Presentation - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP BO-S7] Impact of Adjuvant Therapy on Resected Invasive Intraductal Papillary Mucinous Neoplasm of the Pancreas : an Korean Multicenter Cohort Study
Munseok CHOI 1, In W. HAN 2, Koo Jeong KANG 18, Joon Seong PARK 3, Dong Do YOU 16, Seok Jeong YANG 5, Seung Eun LEE 6, Hyung-Il SEO 7, Myunghee YOON 7, Seungjae LEE 8, Min Su PARK 9, Yoo‑Seok YOON 11, Sung-Sik HAN 12, Huisong LEE 13, Jae Do YANG 14, Jun Chul JUNG 15, Jin Ho LEE 16, Jin-Young JANG 10, Song-Cheol KIM 4, Chang Moo KANG 19
1 Department of Surgery , Yongin Severance Hospital, REPUBLIC OF KOREA, 2 Department of Surgery , Samsung Medical Center, REPUBLIC OF KOREA, 3 Department of Surgery , Gangnam Severance Hospital, REPUBLIC OF KOREA, 4 Department of Surgery , Asan Medical Center, REPUBLIC OF KOREA, 5 Department of Surgery , Bundang CHA, REPUBLIC OF KOREA, 6 Department of Surgery , Chung-Ang University Hospital, REPUBLIC OF KOREA, 7 Department of Surgery , Pusan National University Hospital, REPUBLIC OF KOREA, 8 Department of Surgery , Konyang University Hospital, REPUBLIC OF KOREA, 9 Department of Surgery , Kyung Hee University Medical Center, REPUBLIC OF KOREA, 10 Department of Surgery , Seoul National University Hospital, REPUBLIC OF KOREA, 11 Department of Surgery , Seoul National University Bundang Hospital, REPUBLIC OF KOREA, 12 Department of Surgery , National Cancer Center, REPUBLIC OF KOREA, 13 Department of Surgery , Ewha Womans University Mokdong Hospital, REPUBLIC OF KOREA, 14 Department of Surgery , Chonbuk National University Hospital, REPUBLIC OF KOREA, 15 Department of Surgery , Soon Chun Hyang University Bucheon Hospital, REPUBLIC OF KOREA, 16 Department of Surgery , National Health Insurance Service Ilsan Hospital, REPUBLIC OF KOREA, 17 Department of Surgery , The Catholic University of Korea St. Vincent's Hospital, REPUBLIC OF KOREA, 18 Department of Surgery , Keimyung University Dongsan Medical Center, REPUBLIC OF KOREA, 19 Department of Surgery , Severance Hospital, REPUBLIC OF KOREA
Background : Adjuvant therapy (AT) has demonstrated survival benefits in patients with pancreatic ductal adenocarcinoma (PDAC). However, the oncologic efficacy of AT in resected invasive intraductal papillary mucinous neoplasms (IPMN) remains unclear, and there are no established guidelines.
Methods : A retrospective analysis was conducted on 618 patients with invasive IPMN treated between 2005 and 2020 across 18 centers in Korea. Propensity score-matched analysis (PSM) and stage-matched survival analysis were performed.
Results : After exclusions, 539 patients were included in the study. In a PSM, 354 patients were enrolled. Multivariate analysis identified perineural invasion (HR, 2.589; 95% CI, 1.528-4.385, p < 0.001) and CA 19-9 > 37 (HR, 2.589; 95% CI, 1.528-4.385, p < 0.001) as adverse prognostic factors. There were no significant differences in disease-free survival (DFS) and overall survival (OS) between the surgery alone (SA) group and AT group (p = 0.882, p = 0.080). Likewise, in the stage-matched analysis, no significant differences in OS were observed between the SA and AT groups (stage I, p = 0.621; stage II, p = 0.662, stage III, p = 0.571). While DFS was improved in the stage I group with SA group (p = 0.020), this benefit was not observed in other stages (stage II, p = 0.452, stage III, p = 0.492). Subgroup analysis by perineural invasion and CA 19-9 > 37 status did not show a survival benefit with AT (PNI+, p = 0.568; CA 19-9 > 37, p = 0.703).
Conclusions : The current AT strategy may not be recommended for resected invasive IPMN.
Methods : A retrospective analysis was conducted on 618 patients with invasive IPMN treated between 2005 and 2020 across 18 centers in Korea. Propensity score-matched analysis (PSM) and stage-matched survival analysis were performed.
Results : After exclusions, 539 patients were included in the study. In a PSM, 354 patients were enrolled. Multivariate analysis identified perineural invasion (HR, 2.589; 95% CI, 1.528-4.385, p < 0.001) and CA 19-9 > 37 (HR, 2.589; 95% CI, 1.528-4.385, p < 0.001) as adverse prognostic factors. There were no significant differences in disease-free survival (DFS) and overall survival (OS) between the surgery alone (SA) group and AT group (p = 0.882, p = 0.080). Likewise, in the stage-matched analysis, no significant differences in OS were observed between the SA and AT groups (stage I, p = 0.621; stage II, p = 0.662, stage III, p = 0.571). While DFS was improved in the stage I group with SA group (p = 0.020), this benefit was not observed in other stages (stage II, p = 0.452, stage III, p = 0.492). Subgroup analysis by perineural invasion and CA 19-9 > 37 status did not show a survival benefit with AT (PNI+, p = 0.568; CA 19-9 > 37, p = 0.703).
Conclusions : The current AT strategy may not be recommended for resected invasive IPMN.
SESSION
BP Best Oral Presentation
Room A 3/22/2024 1:30 PM - 2:50 PM