Optimal Preoperative Multidisciplinary Treatment in Borderline Resectable Pancreatic Cancer

Nana Kimura; Suguru Yamada; Hideki Takami; Kenta Murotani; Isaku Yoshioka; Kazuto Shibuya; Fuminori Sonohara; Yui Hoshino; Katsuhisa Hirano; Toru Watanabe; Hayato Baba; Kosuke Mori; Takeshi Miwa; Mitsuro Kanda; Masamichi Hayashi; Koshi Matsui; Tomoyuki Okumura; Yasuhiro Kodera; Tsutomu Fujii

doi:10.3390/cancers13010036

Cancers (Dec 2020)

Optimal Preoperative Multidisciplinary Treatment in Borderline Resectable Pancreatic Cancer

Nana Kimura,
Suguru Yamada,
Hideki Takami,
Kenta Murotani,
Isaku Yoshioka,
Kazuto Shibuya,
Fuminori Sonohara,
Yui Hoshino,
Katsuhisa Hirano,
Toru Watanabe,
Hayato Baba,
Kosuke Mori,
Takeshi Miwa,
Mitsuro Kanda,
Masamichi Hayashi,
Koshi Matsui,
Tomoyuki Okumura,
Yasuhiro Kodera,
Tsutomu Fujii

Affiliations

Nana Kimura: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Suguru Yamada: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Hideki Takami: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Kenta Murotani: Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka 8300011, Japan
Isaku Yoshioka: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Kazuto Shibuya: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Fuminori Sonohara: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Yui Hoshino: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Katsuhisa Hirano: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Toru Watanabe: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Hayato Baba: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Kosuke Mori: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Takeshi Miwa: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Mitsuro Kanda: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Masamichi Hayashi: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Koshi Matsui: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Tomoyuki Okumura: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan
Yasuhiro Kodera: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya 4668550, Aichi, Japan
Tsutomu Fujii: Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 9300194, Japan

DOI: https://doi.org/10.3390/cancers13010036
Journal volume & issue: Vol. 13, no. 1
p. 36

Abstract

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Background: The objective of this study was to investigate the optimal neoadjuvant therapy (NAT) for borderline resectable pancreatic cancer invading the portal vein (BR-PV) or abutting major arteries (BR-A). Methods: We retrospectively analyzed 88 patients with BR-PV and 111 patients with BR-A. Results: In BR-PV patients who underwent upfront surgery (n = 46)/NAT (n = 42), survival was significantly better in the NAT group (3-year overall survival (OS): 5.8%/35.5%, p = 0.004). In BR-A patients who underwent upfront surgery (n = 48)/NAT (n = 63), survival was also significantly better in the NAT group (3-year OS:15.5%/41.7%, p p = 0.028) and preoperative high prognostic nutritional index (PNI) (p = 0.022) were significantly associated with a favorable prognosis. In 39 BR-A patients who underwent surgery after NAT, multivariate analysis revealed that preoperative PNI > 42.5 was an independent prognostic factor (HR: 0.15, p = 0.014). Conclusions: NAT using newer chemotherapy is essential for improving the prognosis of BR pancreatic cancer. These findings suggest that prognosis may be prolonged by maintaining good nutritional status during preoperative treatment.

Published in Cancers

ISSN: 2072-6694 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/cancers/

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