Role of neoadjuvant treatment in resectable pancreatic cancer according to vessel invasion and increase of CA19-9 levels
- Authors
- Kim, Hyeong Seok; Lee, Mirang; Han, Youngmin; Kang, Jae Seung; Kang, Yoon Hyung; Sohn, Hee Ju; Kwon, Wooil; Lee, Dong Ho; Jang, Jin-Young
- Issue Date
- Jul-2023
- Publisher
- Springer Verlag
- Keywords
- carcinoma; pancreatic ductal; neoadjuvant therapies; survival
- Citation
- Journal of Hepato-Biliary-Pancreatic Sciences, v.30, no.7, pp 924 - 934
- Pages
- 11
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Hepato-Biliary-Pancreatic Sciences
- Volume
- 30
- Number
- 7
- Start Page
- 924
- End Page
- 934
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62752
- DOI
- 10.1002/jhbp.1302
- ISSN
- 1868-6974
1868-6982
- Abstract
- Background/Purpose
The efficacy of neoadjuvant treatment (NAT) for resectable pancreatic cancer remains debatable, particularly in patients with portal vein (PV)/superior mesenteric vein (SMV) contact and elevated serum carbohydrate antigen (CA) 19-9. This study investigated the clinical significance of PV/SMV contact and CA19-9 levels, and the role of NAT in resectable pancreatic cancer.
Methods
A total of 775 patients who underwent surgery for resectable pancreatic cancer between 2007 and 2018 were included. Propensity score-matched (PSM) analysis (1:3) was performed based on tumor size, lymph node enlargement, and PV/SMV contact. Subgroup analyses were performed according to PV/SMV contact and CA19-9 level.
Results
Among the patients, 52 underwent NAT and 723 underwent upfront surgery. After PSM, NAT group showed better survival than upfront surgery group (median 30.0 vs 22.0 months, P = .047). In patients with PV/SMV contact, NAT tended to have better survival (30.0 vs 22.0 months, P = .069). CA19-9 >150 U/mL was a poor prognostic factor, with NAT showing a significant survival difference compared with upfront surgery (34.0 vs 18.0 months, P = .004).
Conclusions
Neoadjuvant treatment showed better survival than upfront surgery in resectable pancreatic cancer. In patients with PV/SMV contact or CA19-9 >150 U/mL, NAT showed a survival difference compared to upfront surgery; therefore, NAT could be considered in these patients.
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- Appears in
Collections - 2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
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