Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 213] Neoadjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma with Radiographic Duodenal Invasion
Daisuke SHIRAI 1, Hiroaki HUJI 1, Ikuo NAKAMURA 1, Masaharu TADA 1, Kennjirou IIDA 1, Hideaki SUEOKA 1, Tomohiro OKAMOTO 1, Ami KURIMOTO 1, Takahito HIRAI 1, Takeaki ISHIZAWA 2, Kenjiro KIMURA 2, Chie KITAMI 3, Seiko HIRONO 1
1 Division of Hepato-Biliary-Pancreatic Surgery, Department of Gastroenterological Surgery, Hyogo College of Medicine, JAPAN, 2 Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, JAPAN, 3 Department of Surgery, Nagaoka Chuo General Hospital, JAPAN
Background : Pancreatic ductal adenocarcinoma (PDAC) with duodenal invasion is not included in the definition of borderline resectable - PDAC, but is known to be associated with poor prognosis. In this study, we investigated the short-term prognostic impact of neoadjuvant chemotherapy (NAC) for PDAC with duodenal invasion.
Methods : This study included 135 patients who underwent pancreatoduodenectomy for pancreatic head cancer with duodenal invasion on contrast-enhanced computed tomography images at the initial visit, between January 2013 and December 2022 at our hospital, Osaka Metropolitan University, and Nagaoka Chuo General Hospital. 79 patients underwent up-front surgery (UFS group) and 56 patient received NAC before surgery (NAC group).
Results : There was no difference between the NAC and UFS groups in tumor size (27 vs. 26 mm, P=0.56), CA19-9 level (127 vs. 152 ng/ml, P=0.94) at the initial visit. At the pathologic findings, tumor size was shrunk significantly more in the NAC group than in the UFS groups (25 vs. 30 mm, P=0.013). TS-1 was administered as postoperative adjuvant chemotherapy, and was more frequently in the NAC group than the UFS group. (94.5% and 82.9%, respectively (P=0.058)). The 1-year recurrence-free survival were 46% in the UFS group and 58% in the NAC group (P=0.108), and tend to be lower in the NAC group. The 3-year overall survival were 42% and 45%, respectively (P=0.42), and were no difference between the two group.
Conclusions : NAC for PDAC with duodenal invasion may improve recurrence free survival compared with UFS.
Methods : This study included 135 patients who underwent pancreatoduodenectomy for pancreatic head cancer with duodenal invasion on contrast-enhanced computed tomography images at the initial visit, between January 2013 and December 2022 at our hospital, Osaka Metropolitan University, and Nagaoka Chuo General Hospital. 79 patients underwent up-front surgery (UFS group) and 56 patient received NAC before surgery (NAC group).
Results : There was no difference between the NAC and UFS groups in tumor size (27 vs. 26 mm, P=0.56), CA19-9 level (127 vs. 152 ng/ml, P=0.94) at the initial visit. At the pathologic findings, tumor size was shrunk significantly more in the NAC group than in the UFS groups (25 vs. 30 mm, P=0.013). TS-1 was administered as postoperative adjuvant chemotherapy, and was more frequently in the NAC group than the UFS group. (94.5% and 82.9%, respectively (P=0.058)). The 1-year recurrence-free survival were 46% in the UFS group and 58% in the NAC group (P=0.108), and tend to be lower in the NAC group. The 3-year overall survival were 42% and 45%, respectively (P=0.42), and were no difference between the two group.
Conclusions : NAC for PDAC with duodenal invasion may improve recurrence free survival compared with UFS.
SESSION
E-poster
E-Session 03/21 ALL DAY