The involvement of the hepatic artery is a risk factor for unresectability after neoadjuvant treatment in borderline pancreatic adenocarcinoma

IF 2.3 4区 医学 Q3 ONCOLOGY Surgical Oncology-Oxford Pub Date : 2023-12-11 DOI:10.1016/j.suronc.2023.102027
Luis Secanella , Juli Busquets , Núria Peláez , María Sorribas , Berta Laquente , Sandra Ruiz-Osuna , Juan Fabregat
{"title":"The involvement of the hepatic artery is a risk factor for unresectability after neoadjuvant treatment in borderline pancreatic adenocarcinoma","authors":"Luis Secanella ,&nbsp;Juli Busquets ,&nbsp;Núria Peláez ,&nbsp;María Sorribas ,&nbsp;Berta Laquente ,&nbsp;Sandra Ruiz-Osuna ,&nbsp;Juan Fabregat","doi":"10.1016/j.suronc.2023.102027","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Borderline Resectable Pancreatic Ductal Adenocarcinoma (BR-PDAC) benefits from neoadjuvant treatment (NAT) with the intent of surgical salvage in the absence of disease progression during chemotherapy (CT) or chemoradiotherapy (CRT). Scarce literature exists about prognostic factors of resectability at the time of diagnosis or during neoadjuvant treatment, especially regarding vascular relationships.</p></div><div><h3>Materials</h3><p>We reviewed our prospective BR-PDAC cohort to determine resectability predictors. We collected data about clinical baseline characteristics, vessels’ involvement, type of NAT, CA19-9 evolution, and radiological outcome. We performed a descriptive analysis and a logistic regression model to define resectability predictors; we finally compared overall survival (OS) and progression-free survival (PFS) for those predictors.</p></div><div><h3>Results</h3><p>One hundred patients started NAT, with a resection rate of 44 % (40 pancreaticoduodenectomies, 4 distal pancreatectomies). The most frequent vessel relationship was the abutment of the superior mesenteric artery (44 %), and 26 patients had ≥2 vessels involved. Prognostic factors of resectability were CA19-9 response &gt;10 % (OR 3.07, p = 0.016) and Hepatic Artery involvement (OR 0.21, p = 0.026). Median overall survival was better for CA19-9 responders than for non-responders (20.9 months and 11.8 months respectively, p &lt; 0.001), and similar to normalized CA19-9 (25.0 months, p = 0.48). There were no differences in terms of OS or PFS with the involvement of the HA (17.7 vs 17.1 months, p = 0.367; and 8.7 vs 12.0 months, p = 0.267).</p></div><div><h3>Conclusion</h3><p>The involvement of the Hepatic Artery seems to confer a worse prognosis regarding resectability. A decrease of only &gt;10 % of CA19-9 is a predictive factor for resectability and better overall and progression-free survival.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740423001275/pdfft?md5=6066b817b027eed085fbeadf2c8a6a0a&pid=1-s2.0-S0960740423001275-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Oncology-Oxford","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0960740423001275","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Borderline Resectable Pancreatic Ductal Adenocarcinoma (BR-PDAC) benefits from neoadjuvant treatment (NAT) with the intent of surgical salvage in the absence of disease progression during chemotherapy (CT) or chemoradiotherapy (CRT). Scarce literature exists about prognostic factors of resectability at the time of diagnosis or during neoadjuvant treatment, especially regarding vascular relationships.

Materials

We reviewed our prospective BR-PDAC cohort to determine resectability predictors. We collected data about clinical baseline characteristics, vessels’ involvement, type of NAT, CA19-9 evolution, and radiological outcome. We performed a descriptive analysis and a logistic regression model to define resectability predictors; we finally compared overall survival (OS) and progression-free survival (PFS) for those predictors.

Results

One hundred patients started NAT, with a resection rate of 44 % (40 pancreaticoduodenectomies, 4 distal pancreatectomies). The most frequent vessel relationship was the abutment of the superior mesenteric artery (44 %), and 26 patients had ≥2 vessels involved. Prognostic factors of resectability were CA19-9 response >10 % (OR 3.07, p = 0.016) and Hepatic Artery involvement (OR 0.21, p = 0.026). Median overall survival was better for CA19-9 responders than for non-responders (20.9 months and 11.8 months respectively, p < 0.001), and similar to normalized CA19-9 (25.0 months, p = 0.48). There were no differences in terms of OS or PFS with the involvement of the HA (17.7 vs 17.1 months, p = 0.367; and 8.7 vs 12.0 months, p = 0.267).

Conclusion

The involvement of the Hepatic Artery seems to confer a worse prognosis regarding resectability. A decrease of only >10 % of CA19-9 is a predictive factor for resectability and better overall and progression-free survival.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
肝动脉受累是边缘型胰腺腺癌新辅助治疗后无法切除的一个风险因素
导言边缘可切除胰腺导管腺癌(BR-PDAC)可从新辅助治疗(NAT)中获益,新辅助治疗的目的是在化疗(CT)或化放疗(CRT)期间疾病未进展的情况下进行手术挽救。有关诊断时或新辅助治疗期间可切除性的预后因素,尤其是血管关系的文献很少。我们收集了有关临床基线特征、血管受累情况、NAT类型、CA19-9演变情况和放射学结果的数据。我们进行了描述性分析和逻辑回归模型,以确定可切除性预测因素;最后比较了这些预测因素的总生存期(OS)和无进展生存期(PFS)。最常见的血管关系是肠系膜上动脉(44%),26 例患者累及≥2 条血管。可切除性的预后因素是CA19-9反应>10%(OR 3.07,p = 0.016)和肝动脉受累(OR 0.21,p = 0.026)。CA19-9应答者的中位总生存期优于未应答者(分别为20.9个月和11.8个月,p = 0.001),与CA19-9正常化者相似(25.0个月,p = 0.48)。在OS或PFS方面,HA受累没有差异(17.7个月 vs 17.1个月,p = 0.367;8.7个月 vs 12.0个月,p = 0.267)。CA19-9仅下降10%是可切除性和较好的总生存期和无进展生存期的预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Surgical Oncology-Oxford
Surgical Oncology-Oxford 医学-外科
CiteScore
4.50
自引率
0.00%
发文量
169
审稿时长
38 days
期刊介绍: Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.
期刊最新文献
Machine learning in cancer prognostication: Limitations and opportunities. Bilobed lateral artery perforator-based flap for partial breast reconstruction - Technique description and results from a ten-year cohort. Individualizing care for patients with gallbladder cancer Natural history of salivary gland secretory carcinoma: A REFCOR study. Tumor necrosis drives prognosis in osteosarcoma: No difference in chemotherapy response and survival between chondroblastic and osteoblastic osteosarcoma
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1