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논문 기본 정보

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저자정보
Yoon Min Sung (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Lee Hee Seung (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Kang Chang Moo (Division of Gastroenterology Department of Hepatobiliary and Pancreatic Surgery Yonsei University C) Lee Woo Jung (Division of Gastroenterology Department of Hepatobiliary and Pancreatic Surgery Yonsei University C) Keum Jiyoung (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Sung Min Je (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Kim Seung-seob (Division of Gastroenterology Department of Radiology and Research Institute of Radiological Science) Park Mi-Suk (Division of Gastroenterology Department of Radiology and Research Institute of Radiological Science) Jo Jung Hyun (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Chung Moon Jae (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Park Jeong Youp (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Park Seung Woo (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Song Si Young (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine) Hwang Ho Kyoung (Division of Gastroenterology Department of Hepatobiliary and Pancreatic Surgery Yonsei University C) Bang Seungmin (Division of Gastroenterology Department of Internal Medicine Yonsei University College of Medicine)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제16권 제1호
발행연도
2022.1
수록면
118 - 128 (11page)
DOI
10.5009/gnl20301

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Background/Aims: Controversy regarding the effectiveness of neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma (PDAC) still exists. Here, we aimed to identify the potential benefits of neoadjuvant therapy followed by surgery for resectable PDAC. Methods: We reviewed radiologically resectable PDAC patients who received resection with curative intent at a tertiary hospital in South Korea between January 2012 and August 2019. A total of 202 patients underwent curative resection for resectable PDAC: 167 underwent surgical resection first during this period, and 35 received neoadjuvant chemotherapy/chemoradiation therapy followed by surgery. Resectable PDAC patients were subdivided, and 1:3 propensity score matching (PSM) was performed to reduce selection bias. Results: Compared with the group that received surgery first, the group that received neoadjuvant treatment followed by surgery had significantly smaller tumors (22.0 mm vs 27.0 mm, p=0.004), a smaller proportion of patients with postoperative pathologic T stage (p=0.026), a smaller proportion of patients with lymphovascular invasion (20.0% vs 40.7%, p=0.022), and a larger proportion of patients with negative resection margins (74.3% vs 51.5%, p=0.049). After PSM, the group that received neoadjuvant therapy had a significantly longer progression-free survival than those in the group that underwent surgery first (29.6 months vs 15.1 months, p=0.002). Overall survival was not significantly different between the two groups after PSM analysis. Conclusions: We observed significantly better surgical outcomes and progression-free survival with the addition of neoadjuvant therapy to the management of resectable PDAC. However, despite PSM, there was still selection bias due to the use of different regimens between the groups receiving surgery first and neoadjuvant therapy. Large homogeneous samples are needed in the future prospective studies.
#Pancreatic neoplasm #Neoadjuvant therapy #Surgical outcome #Progression-free survival

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