Prognosticators for Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Therapy and Pancreatectomy

被引:5
|
作者
Tong, Yi Tat [1 ]
Lai, Zongshan [1 ]
Katz, Matthew H. G. [2 ]
Prakash, Laura R. [2 ]
Wang, Hua [3 ]
Chatterjee, Deyali [1 ]
Kim, Michael [2 ]
Tzeng, Ching-Wei D. [2 ]
Lee, Jeffrey E. E. [2 ]
Ikoma, Naruhiko [2 ]
Rashid, Asif [1 ]
Wolff, Robert A. [3 ]
Zhao, Dan [3 ]
Koay, Eugene J. [4 ]
Maitra, Anirban [1 ,5 ]
Wang, Huamin [1 ,5 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Pathol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Gastrointestinal Med Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA
[5] Univ Texas MD Anderson Canc Ctr, Dept Translat Mol Pathol, 1515 Holcombe Blvd, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
pancreatic cancer; neoadjuvant therapy; FOLFIRINOX; gemcitabine/nab-paclitaxel; tumor response grade; tumor stage; lymph node metastasis; survival; PREDICTS POOR-PROGNOSIS; NAB-PACLITAXEL; CANCER; SURVIVAL; PANCREATICODUODENECTOMY; CHEMORADIATION; INVASION;
D O I
10.3390/cancers15092608
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Neoadjuvant FOLFIRINOX and gemcitabine/nab-paclitaxel (GemNP) therapies are increasingly used to treat patients with pancreatic ductal adenocarcinoma (PDAC). However, limited data are available on their clinicopathologic prognosticators. We examined the clinicopathologic factors and survival of 213 PDAC patients who received FOLFIRINOX with 71 patients who received GemNP. The FOLFIRINOX group was younger (p < 0.01) and had a higher rate of radiation (p = 0.049), higher rate of borderline resectable and locally advanced disease (p < 0.001), higher rate of Group 1 response (p = 0.045) and lower ypN stage (p = 0.03) than the GemNP group. Within FOLFIRINOX group, radiation was associated with decreased lymph node metastasis (p = 0.01) and lower ypN stage (p = 0.01). The tumor response group, ypT, ypN, LVI and PNI, correlated significantly with both DFS and OS (p < 0.05). Patients with the ypT0/T1a/T1b tumor had better DFS (p = 0.04) and OS (p = 0.03) than those with ypT1c tumor. In multivariate analysis, the tumor response group and ypN were independently prognostic factors for DFS and OS (p < 0.05). Our study demonstrated that the FOLFIRINOX group was younger and had a better pathologic response than the GemNP group and that the tumor response group, ypN, ypT, LVI and PNI, are significant prognostic factors for survival in these patients. Our results also suggest that the tumor size of 1.0 cm is a better cut off for ypT2. Our study highlights the importance of systemic pathologic examination and the reporting of post-treatment pancreatectomies.
引用
收藏
页数:15
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