Pathological treatment response has different prognostic implications for pancreatic cancer patients treated with neoadjuvant chemotherapy or chemoradiotherapy
Pathological treatment response has different prognostic implications for pancreatic cancer patients treated with neoadjuvant chemotherapy or chemoradiotherapy
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DOI：
10.1016/j.surg.2021.10.015
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发表时间：
2022-04-25
期刊：
影响因子：
3.8
通讯作者：
Donahue, Timothy R.
中科院分区：
文献类型：
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作者：
Maeda, Shimpei;Mederos, Michael A.;Donahue, Timothy R.
背景：胰腺癌切除后新辅助治疗的病理治疗效果具有预后意义。方法：回顾性分析2011年至2017年3家中心接受新辅助治疗后行胰腺切除术的局限性胰腺癌患者。结果：525例患者中，148例接受新辅助化疗，377例接受放化疗。放化疗组疗效（0分：10%，1分：30%，2分：42%，3分：18%）优于化疗组（0分：2%，1分：8%，2分：35%，3分：55%）（P < .001）。两组的中位总生存期相似（25.8 vs 26.4个月）。评分为0/1、2或3分的中位总生存期在化疗组为72.2、38.5和20.0个月，在放化疗组为37.9、24.5和19.0个月。与3分相比，化疗组2分与更好的总生存率相关（调整后的风险比：0.49，P = .005），而只有综合评分0/1达到显着超过2分的放化疗组（风险比：0.63，P = .006）。对于接受新辅助化疗或新辅助放化疗的局限性胰腺癌患者，病理治疗效果的预后意义不同。(C)2021爱思唯尔公司All rights reserved.
Background: Pathological treatment effect of resected pancreatic adenocarcinoma after neoadjuvant therapy has prognostic implications. The impact for patients who received chemotherapy alone or chemoradiotherapy is not well defined.Methods: Patients with localized pancreatic adenocarcinoma who had pancreatectomy after neoadjuvant therapy at 3 centers from 2011 to 2017 were retrospectively analyzed. The chemotherapy and chemo-radiotherapy groups were evaluated separately.Results: Of 525 patients, 148 received neoadjuvant chemotherapy and 377 received chemoradiotherapy. The chemoradiotherapy group had a better treatment effect (score 0: 10%, score 1: 30%, score 2: 42%, and score 3: 18%) than the chemotherapy group (score 0: 2%, score 1: 8%, score 2: 35%, and score 3: 55%) (P < .001). Median overall survival was similar between the 2 groups (25.8 vs 26.4 months). Median overall survival for score 0/1, 2, or 3 was 72.2, 38.5, and 20.0 months in the chemotherapy group and 37.9, 24.5, and 19.0 months in the chemoradiotherapy group. Score 2 in the chemotherapy group was associated with better overall survival compared to score 3 (adjusted hazard ratio: 0.49, P = .005), whereas only combined score 0/1 reached significance over score 2 for the chemoradiotherapy group (hazard ratio: 0.63, P = .006).Conclusion: The prognostic significance of pathological treatment effect for localized pancreatic adeno-carcinoma differs for patients receiving neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy. (C) 2021 Elsevier Inc. All rights reserved.