Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 140] Investigation of Response Marker in Patients with Neoadjuvant Treatment for Pancreatic Cancer Followed by Surgical Resection
Hochang CHAE 1, So Jeong YOON 1, Hyeng Seok KIM 1, Soo Yeun LIM 1, Hye Jeong JEONG 1, Sang Hyun SHIN 1, In Woong HAN 1, Jin Seok HEO 1, Hongbeom KIM 1
1 Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, REPUBLIC OF KOREA
Background : Standard treatment for borderline resectable pancreatic cancer involves neoadjuvant therapy followed by surgical resection. This approach is extended to resectable pancreatic cancer cases. However, determining the optimal timing for surgery after neoadjuvant treatment is controversial. Therefore, we conducted analysis of the outcomes of patients undergoing pancreatic resection following neoadjuvant chemotherapy.
Methods : We analyzed patients who underwent pancreatic surgery and were diagnosed with pancreatic ductal adenocarcinoma through histopathological reports from January 2018 to December 2021, at Samsung Medical Center. Patients were included who received FOLFIRINOX-based neoadjuvant treatment. The laboratory test results, including CA 19-9, available imaging data such as CT and PET CT, operative information, and postoperative data such as information on recurrence or death were collected for the analysis.
Results : Total 83 patients were included in this study. Pancreaticoduodenectomy was performed in 59 patients, distal pancreatectomy in 20 patients, and total pancreatectomy in 4 patients. After neoadjuvant treatment, 1 patient achieved complete remission, 33 patients showed partial response, 46 patients had stable disease, and 3 patients experienced progressive disease. When analyzing overall survival and disease-free survival in the patient cohort, patients with initial CA 19-9 elevation (>37) who achieved normalization after neoadjuvant treatment showed a 3-year disease-free survival of 32.5%, whereas the other patients who did not achieve normalization had a 3-year disease-free survival of 0.0% (p=0.016).
Conclusions : In conclusion, whether to perform surgery and the timing of surgery after neoadjuvant treatment should be decided considering tumor size and CA 19-9 value.
Methods : We analyzed patients who underwent pancreatic surgery and were diagnosed with pancreatic ductal adenocarcinoma through histopathological reports from January 2018 to December 2021, at Samsung Medical Center. Patients were included who received FOLFIRINOX-based neoadjuvant treatment. The laboratory test results, including CA 19-9, available imaging data such as CT and PET CT, operative information, and postoperative data such as information on recurrence or death were collected for the analysis.
Results : Total 83 patients were included in this study. Pancreaticoduodenectomy was performed in 59 patients, distal pancreatectomy in 20 patients, and total pancreatectomy in 4 patients. After neoadjuvant treatment, 1 patient achieved complete remission, 33 patients showed partial response, 46 patients had stable disease, and 3 patients experienced progressive disease. When analyzing overall survival and disease-free survival in the patient cohort, patients with initial CA 19-9 elevation (>37) who achieved normalization after neoadjuvant treatment showed a 3-year disease-free survival of 32.5%, whereas the other patients who did not achieve normalization had a 3-year disease-free survival of 0.0% (p=0.016).
Conclusions : In conclusion, whether to perform surgery and the timing of surgery after neoadjuvant treatment should be decided considering tumor size and CA 19-9 value.
SESSION
E-poster
E-Session 03/21 ALL DAY