Yeshong Park , Yeon Bi Han , Jinju Kim , MeeYoung Kang , Boram Lee , Eun Sung Ahn , Saemi Han , Haeryoung Kim , Hee-Young Na , Ho-Seong Han , Yoo-Seok Yoon
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Patients were divided into small extent (SE; <em>n</em> = 26) and large extent (LE; <em>n</em> = 26) groups using a cutoff value of 226 mm<sup>2</sup>. The diagnostic performance for predicting tumor recurrence was evaluated using receiver operating characteristic (ROC) curves.</p></div><div><h3>Results</h3><p>Carbohydrate antigen 19-9 levels were normalised after NAT in more patients in the SE group (SE 21 [80.8%] vs. LE 13 [50.0%]; <em>P</em> = 0.041). Tumor size (<em>P</em> < 0.001), T stage (<em>P</em> < 0.001), positive lymph node yield (<em>P</em> = 0.024), and perineural invasion rate (<em>P</em> = 0.018) were significantly greater in the LE group. The 3-year disease-free survival rate was significantly lower in the LE group (SE 83.3% vs. LE 50.0%, <em>P</em> = 0.004). The area under the ROC curve for mapping extent was 0.743, which was greater than that of the other tumor response scoring systems.</p></div><div><h3>Conclusions</h3><p>Microscopic tumor mapping of the residual tumor in post-NAT specimens is a significant predictor of post-surgical recurrence, and offers better prognostic performance than the current grading systems.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Microscopic tumor mapping of post-neoadjuvant therapy pancreatic cancer specimens to predict post-surgical recurrence: A prospective cohort study\",\"authors\":\"Yeshong Park , Yeon Bi Han , Jinju Kim , MeeYoung Kang , Boram Lee , Eun Sung Ahn , Saemi Han , Haeryoung Kim , Hee-Young Na , Ho-Seong Han , Yoo-Seok Yoon\",\"doi\":\"10.1016/j.pan.2024.03.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Although various pathological grading systems are available for evaluating the response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant therapy (NAT), their prognostic value has not been thoroughly validated. 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引用次数: 0
摘要
背景:尽管有多种病理分级系统可用于评估胰腺导管腺癌(PDAC)对新辅助治疗(NAT)的反应,但其预后价值尚未得到彻底验证。本研究探讨了新辅助治疗后标本的显微肿瘤图谱能否预测肿瘤复发:这项前瞻性研究纳入了2019年至2021年间因PDAC接受NAT后胰十二指肠切除术的52名患者。使用 4 平方毫米像素进行显微绘图,以确定肿瘤床内的残余肿瘤位置。以226平方毫米为临界值,将患者分为小范围组(SE;n = 26)和大范围组(LE;n = 26)。使用接收器操作特征曲线(ROC)评估了预测肿瘤复发的诊断性能:结果:更多 SE 组患者(SE 21 [80.8%] vs. LE 13 [50.0%]; P = 0.041)在 NAT 后碳水化合物抗原 19-9 水平恢复正常。肿瘤大小(PNAT 术后标本中残留肿瘤的显微镜下肿瘤图谱是手术后复发的重要预测指标,其预后效果优于目前的分级系统。
Microscopic tumor mapping of post-neoadjuvant therapy pancreatic cancer specimens to predict post-surgical recurrence: A prospective cohort study
Background
Although various pathological grading systems are available for evaluating the response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant therapy (NAT), their prognostic value has not been thoroughly validated. This study examined whether microscopic tumor mapping of post-NAT specimens could predict tumor recurrence.
Methods
This prospective study enrolled 52 patients who underwent pancreaticoduodenectomy after NAT for PDAC between 2019 and 2021. Microscopic mapping was performed to identify residual tumor loci within the tumor bed using 4 mm2 pixels. Patients were divided into small extent (SE; n = 26) and large extent (LE; n = 26) groups using a cutoff value of 226 mm2. The diagnostic performance for predicting tumor recurrence was evaluated using receiver operating characteristic (ROC) curves.
Results
Carbohydrate antigen 19-9 levels were normalised after NAT in more patients in the SE group (SE 21 [80.8%] vs. LE 13 [50.0%]; P = 0.041). Tumor size (P < 0.001), T stage (P < 0.001), positive lymph node yield (P = 0.024), and perineural invasion rate (P = 0.018) were significantly greater in the LE group. The 3-year disease-free survival rate was significantly lower in the LE group (SE 83.3% vs. LE 50.0%, P = 0.004). The area under the ROC curve for mapping extent was 0.743, which was greater than that of the other tumor response scoring systems.
Conclusions
Microscopic tumor mapping of the residual tumor in post-NAT specimens is a significant predictor of post-surgical recurrence, and offers better prognostic performance than the current grading systems.
期刊介绍:
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.