Prognosticators for Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Therapy and Pancreatectomy
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Pathologic Examination of the Pancreatectomy Specimens
2.3. Clinical Data and Follow Up
2.4. Statistical Analysis
3. Results
3.1. Comparison of the Clinical and Pathologic Characteristics and Survival between the FOLFIRINOX Group and the GemNP Group
3.2. Tumor Response Grade to Neoadjuvant Therapy Correlates with the Survival
3.3. Correlation of Other Pathologic Parameters with Survival
3.4. Multivariate Cox Regression Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinicopathologic Features | FOLFORINOX Group N (%) | GemNP Group N (%) | p Values |
---|---|---|---|
Gender | 0.34 | ||
Female | 97 (45.5) | 37(52.1) | |
Male | 116 (54.5) | 34 (47.9) | |
Mean age ± SD (years) | 62.1 ± 8.8 | 68.1 ± 9.7 | <0.001 |
Clinical tumor classification | <0.001 | ||
Potentially resectable | 81 (38.0) | 54 (76.1) | |
Borderline resectable | 103 (48.4) | 11 (15.5) | |
Locally advanced | 29 (13.6) | 6 (8.4) | |
Neoadjuvant radiation | 0.049 | ||
No | 55 (25.8) | 27 (38.0) | |
Yes | 158 (74.2) | 44 (62.0) | |
Type of surgery | 0.11 | ||
Pancreaticoduodenectomy | 158 (74.2) | 59 (83.1) | |
Distal pancreatectomy | 45 (21.1) | 12 (16.9) | |
Total pancreatectomy | 10 (4.7) | 0 (0.0) | |
Pathologic tumor stage | 0.46 | ||
ypT0 | 10 (4.7) | 1 (1.4) | |
ypT1 | 48 (22.5) | 15 (21.1) | |
ypT2 | 108 (50.7) | 42 (59.2) | |
ypT3 | 47 (22.1) | 13 (18.3) | |
Pathologic lymph node stage | 0.03 * | ||
ypN0 | 107 (50.2) | 27 (38.0) | |
ypN1 | 74 (34.8) | 26 (36.6) | |
ypN2 | 32 (15.0) | 18 (25.4) | |
Margin status | 0.63 | ||
Negative | 165 (77.5) | 53 (74.6) | |
Positive | 48 (22.5) | 18 (25.4) | |
CAP grading | 0.29 | ||
0 | 10 (4.7) | 1 (1.4) | |
1 | 24 (11.3) | 4 (5.6) | |
2 | 96 (45.0) | 34 (47.9) | |
3 | 83 (39.0) | 32 (45.1) | |
MD Anderson grading | 0.16 | ||
0 | 10 (4.7) | 1 (1.4) | |
1 | 24 (11.3) | 4 (5.6) | |
2 | 179 (84.0) | 66 (93.0) | |
Tumor response group | 0.045 ** | ||
Group 1 | 34 (16.0) | 5 (7.0) | |
Group 2 | 179 (84.0) | 66 (93.0) | |
Recurrence | 0.67 | ||
No | 75 (35.2) | 27 (38.0) | |
Yes | 138 (64.8) | 44 (62.0) |
Clinicopathologic Features | FOLFORINOX Alone | FOLFORINOX with RT | p Values | GemNP Alone | GemNP with RT | p Values |
---|---|---|---|---|---|---|
Gender | 0.54 | 0.13 | ||||
Female | 27 | 70 | 11 | 26 | ||
Male | 28 | 88 | 16 | 18 | ||
Mean age ± SD (years) | 62.0 ± 8.4 | 62.2 ± 9.0 | 0.89 | 66.8 ± 8.9 | 68.8 ± 10.2 | 0.40 |
Clinical tumor classification | <0.001 | 0.03 | ||||
Potentially resectable | 36 | 45 | 25 | 29 | ||
Borderline resectable | 10 | 93 | 2 | 9 | ||
Locally advanced | 9 | 20 | 0 | 6 | ||
Type of surgery | 0.22 | 0.35 | ||||
Pancreaticoduodenectomy | 36 | 122 | 21 | 38 | ||
Distal pancreatectomy | 16 | 29 | 6 | 6 | ||
Total pancreatectomy | 3 | 7 | 0 | 0 | ||
Pathologic tumor stage | 0.48 | 0.42 | ||||
ypT0 | 3 | 7 | 0 | 1 | ||
ypT1 | 14 | 34 | 4 | 11 | ||
ypT2 | 30 | 78 | 16 | 26 | ||
ypT3 | 8 | 39 | 7 | 6 | ||
Pathologic lymph node stage | 0.01 | 0.39 | ||||
ypN0 | 20 | 87 | 8 | 19 | ||
ypN1 | 28 | 46 | 10 | 16 | ||
ypN2 | 7 | 25 | 9 | 9 | ||
Lymphovascular invasion | 0.20 | 0.35 | ||||
Negative | 23 | 82 | 11 | 23 | ||
Positive | 32 | 76 | 16 | 21 | ||
Perineural invasion | 0.90 | 0.14 | ||||
Negative | 13 | 36 | 2 | 9 | ||
Positive | 42 | 122 | 25 | 35 | ||
Margin status | 0.20 | 0.64 | ||||
Negative | 46 | 119 | 21 | 32 | ||
Positive | 9 | 39 | 6 | 12 | ||
Tumor response group | 0.45 | 0.93 | ||||
Group 1 | 7 | 27 | 2 | 3 | ||
Group 2 | 48 | 131 | 25 | 41 | ||
Recurrence | 0.23 | 0.89 | ||||
No | 23 | 52 | 10 | 17 | ||
Yes | 32 | 106 | 17 | 27 |
Clinicopathologic Factors | Tumor Response Group | p Values | |
---|---|---|---|
Group 1 N (%) | Group 2 N (%) | ||
Gender | 0.37 | ||
Female | 21 (15.7) | 113 (84.3) | |
Male | 18 (12.0) | 132 (88.0) | |
Mean age ± SD (years) | 58.1 ± 10.2 | 64.5 ± 9.0 | <0.001 |
Neoadjuvant therapy group | 0.045 * | ||
FOLFIRINOX | 34 (16.0) | 179 (84.0) | |
GemNP | 5 (7.0) | 66 (93.0) | |
Neoadjuvant radiation | 0.39 | ||
No | 9 (11.0) | 73 (89.0) | |
Yes | 30 (14.9) | 172 (85.1) | |
Lymphovascular invasion | <0.001 | ||
Negative | 36 (25.9) | 103 (74.1) | |
Positive | 3 (2.1) | 142 (97.9) | |
Perineural invasion | <0.001 | ||
Negative | 28 (46.7) | 32 (53.3) | |
Positive | 11 (4.9) | 213 (95.1) | |
Margin status | 0.04 | ||
Negative | 35 (16.1) | 183 (83.9) | |
Positive | 4 (6.1) | 62 (93.9) | |
ypT stage | <0.001 | ||
ypT0 | 11 (100) | 0 (0.0) | |
ypT1a or 1b | 15 (71.4) | 6 (28.6) | |
ypT1c | 5 (11.9) | 37 (88.1) | |
ypT2 | 6 (4.0) | 144 (96.0) | |
ypT3 | 2 (3.3) | 58 (96.7) | |
ypN stage | <0.001 | ||
ypN0 | 32 (23.9) | 102 (76.1) | |
ypN1 | 5 (5.0) | 95 (95.0) | |
ypN2 | 2 (4.0) | 48 (96.0) | |
Recurrence | <0.001 | ||
No | 25 (24.5) | 77 (75.5) | |
Yes | 14 (7.7) | 168 (92.3) |
Characteristic | No. of Patients | Disease-Free Survival | Overall Survival | ||
---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | ||
Neoadjuvant therapy group | |||||
FOLFORINOX (reference) | 213 | 1.00 | 1.0 | ||
GemNP | 71 | 0.80 (0.57–1.13) | 0.21 | 0.89 (0.56–1.42) | 0.62 |
Perineural invasion | |||||
No (reference) | 60 | 1.00 | 1.0 | ||
Yes | 224 | 0.96 (0.60–1.52) | 0.86 | 0.93 (0.50–1.74) | 0.82 |
Lymphovascular invasion | |||||
No (reference) | 139 | 1.00 | 1.00 | ||
Yes | 145 | 1.09 (0.79–1.52) | 0.59 | 1.34 (0.87–2.07) | 0.18 |
Margin status | |||||
Negative (reference) | 218 | ||||
Positive | 66 | 1.07 (0.75–1.54) | 0.71 | NA | NA |
ypT stage | 0.56 | 0.31 | |||
ypT0 (reference) | 11 | 1.00 | 1.00 | ||
ypT1 | 63 | 1.59 (0.44–5.75) | 0.48 | 1.69 (0.19–15.23) | 0.64 |
ypT2 | 150 | 1.77 (0.48–6.62) | 0.39 | 1.46 (0.16–13.69) | 0.74 |
ypT3 | 60 | 2.11 (0.55–8.08) | 0.27 | 2.24 (0.24–21.35) | 0.48 |
ypN stage | 0.01 | 0.048 | |||
ypN0 (reference) | 134 | 1.00 | 1.00 | ||
ypN1 | 100 | 1.08 (0.77–1.51) | 0.66 | 1.35 (0.86–2.12) | 0.19 |
ypN2 | 50 | 1.77 (1.20–2.62) | 0.004 | 1.90 (1.14–3.17) | 0.01 |
Tumor response group | |||||
Group 1 (reference) | 39 | 1.00 | 1.00 | ||
Group 2 | 245 | 2.78 (1.59–4.88) | <0.001 | 4.13 (1.65–10.35) | 0.002 |
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Tong, Y.T.; Lai, Z.; Katz, M.H.G.; Prakash, L.R.; Wang, H.; Chatterjee, D.; Kim, M.; Tzeng, C.-W.D.; Lee, J.E.; Ikoma, N.; et al. Prognosticators for Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Therapy and Pancreatectomy. Cancers 2023, 15, 2608. https://doi.org/10.3390/cancers15092608
Tong YT, Lai Z, Katz MHG, Prakash LR, Wang H, Chatterjee D, Kim M, Tzeng C-WD, Lee JE, Ikoma N, et al. Prognosticators for Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Therapy and Pancreatectomy. Cancers. 2023; 15(9):2608. https://doi.org/10.3390/cancers15092608
Chicago/Turabian StyleTong, Yi Tat, Zongshan Lai, Matthew H. G. Katz, Laura R Prakash, Hua Wang, Deyali Chatterjee, Michael Kim, Ching-Wei D. Tzeng, Jeffrey E. Lee, Naruhiko Ikoma, and et al. 2023. "Prognosticators for Patients with Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Therapy and Pancreatectomy" Cancers 15, no. 9: 2608. https://doi.org/10.3390/cancers15092608