Tumor budding is an independent adverse prognostic factor of pancreatic ductal adenocarcinoma patients treated by resection after preoperative chemoradiotherapy.

IF 1.7 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pancreas Pub Date : 2024-12-02 DOI:10.1097/MPA.0000000000002440

Aoi Hayasaki, Shugo Mizuno, Miki Usui, Benson Kaluba, Haruna Komatsubara, Tatsuya Sakamoto, Koki Maeda, Toru Shinkai, Daisuke Noguchi, Takahiro Ito, Kazuyuki Gyoten, Yusuke Iizawa, Takehiro Fujii, Akihiro Tanemura, Yasuhiro Murata, Naohisa Kuriyama, Masatoshi Watanabe, Katsunori Uchida, Masashi Kishiwada

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Abstract

Objectives: To examine the significance of tumor budding as a prognostic factor of resected pancreatic ductal adenocarcinoma (PDAC) specimens after preoperative chemoradiotherapy (CRT).

Methods: Among 162 PDAC patients who underwent pancreatectomy after gemcitabine and S1-based CRT from 2012 to 2019, 131 were evaluated for tumor budding. Tumor buds were counted at the invasive front, where the degree of budding was the greatest (hematoxylin and eosin staining, ×20 magnification). Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were compared between the patients without tumor budding (non-TB group) and those with tumor buddings (TB group). Multivariate Cox proportional hazards analysis was conducted to examine the significance of tumor budding as a prognostic factor.

Results: OS, DSS, and RFS (median survival time) of the non-TB group were significantly longer than those of the TB group (OS: 50.7 vs. 27.5 months, P = 0.014. DSS: 63.3 vs. 33.0 months, P = 0.014. RFS: 20.3 vs. 11.3 months, P = 0.028). Multivariate analysis identified adjuvant chemotherapy (P = 0.003) as a favorable prognostic factor of OS and tumor budding (P = 0.023) as an adverse prognostic factor of DSS.

Conclusions: This study revealed that the presence of tumor budding was an independent adverse prognostic factor in PDAC patients resected after gemcitabine and S1-based CRT.

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肿瘤出芽是术前放化疗后行胰腺导管腺癌切除术的一个独立的不良预后因素。

目的：探讨肿瘤出芽作为胰腺导管腺癌（PDAC）切除标本术前放化疗（CRT）后预后因素的意义。方法：2012年至2019年，162例经吉西他滨和S1-based CRT后行胰腺切除术的PDAC患者中，131例进行肿瘤出芽评估。肿瘤芽在浸润前计数，此处芽出程度最大（苏木精和伊红染色，×20放大）。比较无肿瘤出芽（非结核组）和有肿瘤出芽（结核组）患者的总生存期（OS）、疾病特异性生存期（DSS）和无复发生存期（RFS）。多因素Cox比例风险分析检验肿瘤出芽作为预后因素的意义。结果：非TB组的OS、DSS和RFS（中位生存时间）均显著长于TB组（OS: 50.7个月vs. 27.5个月，P = 0.014）。DSS: 63.3 vs. 33.0个月，P = 0.014。RFS: 20.3 vs. 11.3个月，P = 0.028)。多因素分析发现，辅助化疗（P = 0.003）是OS的有利预后因素，肿瘤出芽（P = 0.023）是DSS的不利预后因素。结论：本研究显示肿瘤出芽是吉西他滨和s1基CRT术后切除的PDAC患者的独立不良预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.