Comparison of Tumor Regression Grading of Residual Pancreatic Ductal Adenocarcinoma Following Neoadjuvant Chemotherapy Without Radiation Would Fewer Tier-Stratification Be Favorable Toward Standardization?
Comparison of Tumor Regression Grading of Residual Pancreatic Ductal Adenocarcinoma Following Neoadjuvant Chemotherapy Without Radiation Would Fewer Tier-Stratification Be Favorable Toward Standardization?
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DOI：
10.1097/pas.0000000000001152
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发表时间：
2019-03-01
影响因子：
5.6
通讯作者：
Kim, Grace E.
中科院分区：
文献类型：
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作者：
Kim, Sunhee S.;Ko, Andrew H.;Kim, Grace E.
为了评估美国病理学家学会(CAP)和Evans分级系统在没有放射治疗的胰腺切除标本的情况下进行新辅助化疗是否可以预测预后，以及三层分层方案是否保留了数据粒度。对32例普通胰腺导管腺癌患者行非放疗新辅助治疗后手术切除的临床资料进行回顾性分析。最终病理肿瘤分类(AJCC第8版)分别为46.9%、34.4%和18.7%。中位随访期29.8个月，中位无病生存期19.6个月，中位总生存期34.2个月。CAP评分1分5例(15.6%)，2分18例(56.3%)，3分9例(28.1%)。Evans分级III级10例(31.2%)，IIb级8例(25.0%)，IIa级7例(21.9%)，I级7例(21.9%)。OS(CAP：P=0.005；Evans：P=0.001)和DFS(CAP：P=0.003；Evans：P=0.04)对CAP和Evans均有统计学意义。对于OS(P=0.002)和DFS(P=0.002)，分层CAP1分和2分与CAP3分相比具有统计学意义。Evans分级I级、IIa级和IIb级与Evans III级相比，在OS(P=0.04)和DFS(P=0.02)方面均有统计学意义。CAP、Evans和3层分层是OS和DFS的预后指标。
To assess whether the College of American Pathologists (CAP) and the Evans grading systems for neoadjuvant chemotherapy without radiation-treated pancreatectomy specimens are prognostic, and if a 3-tier stratification scheme preserves data granularity. Conducted retrospective review of 32 patients with ordinary pancreatic ductal adenocarcinoma treated with neoadjuvant therapy without radiation followed by surgical resection. Final pathologic tumor category (AJCC eighth edition) was 46.9% ypT1, 34.4% ypT2, and 18.7% ypT3. Median follow-up time was 29.8 months, median disease-free survival (DFS) was 19.6 months, and median overall survival (OS) was 34.2 months. CAP score 1, 2, 3 were present in 5 (15.6%), 18 (56.3%), and 9 (28.1%) patients, respectively. Evans grade III, IIb, IIa, and I were present in 10 (31.2%), 8 (25.0%), 7 (21.9%), and 7 (21.9%) patients, respectively. OS (CAP: P=0.005; Evans: P=0.001) and DFS (CAP: P=0.003; Evans: P=0.04) were statistically significant for both CAP and Evans. Stratified CAP scores 1 and 2 versus CAP score 3 was statistically significant for both OS (P=0.002) and DFS (P=0.002). Stratified Evans grades I, IIa, and IIb versus Evans grade III was statistically significant for both OS (P=0.04) and DFS (P=0.02). CAP, Evans, and 3-tier stratification are prognostic of OS and DFS.