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. 2023 Feb 9;15(4):1101.
doi: 10.3390/cancers15041101.

Prognosis of Pancreatic Cancer Based on Resectability: A Single Center Experience

Takahiro Einama  1 , Yasuhiro Takihata  1 , Suefumi Aosasa  1   2 , Fukumi Konno  1 , Kazuki Kobayashi  1 , Naoto Yonamine  1 , Ibuki Fujinuma  1 , Takazumi Tsunenari  1 , Akiko Nakazawa  1 , Eiji Shinto  1 , Hideki Ueno  1 , Yoji Kishi  1
Affiliations

Prognosis of Pancreatic Cancer Based on Resectability: A Single Center Experience

Takahiro Einama et al. Cancers (Basel). .

Abstract

Although conversion surgery has increasingly been performed for initially unresectable advanced pancreatic ductal adenocarcinoma (PDAC), the rate of conversion, including that for patients who do not undergo resection, remains unclear. Patients with PDAC who were treated between January 2013 and December 2018 were classified into three groups: resectable (R), borderline resectable (BR), and unresectable (UR). We analyzed patient outcomes, including the rate of surgical resection and survival, in each of these groups. In total, 211 patients (R, 118; BR, 22; UR, 81) were selected. Among them, 117 (99%), 18 (82%), and 15 (19%) patients in the R, BR, and UR groups, respectively, underwent surgical resection. R0 resection rates were 88, 78, and 67%, whereas median overall survival (OS) from treatment initiation were 31, 18, and 11 months (p < 0.0001) in the R, BR, and UR groups, respectively. In patients who underwent surgical resection, relapse-free survival (RFS) and OS were similar among the three groups (R vs. BR vs. UR; median RFS (months), 17 vs. 13 vs. 11, p = 0.249; median OS (months), 31 vs. 26 vs. 32, p = 0.742). Lymph node metastases and incomplete adjuvant chemotherapy were identified as independent prognostic factors for OS. Although the surgical resection rate was low, particularly in the BR and UR groups, the prognosis of patients who underwent surgical resection was similar irrespective of the initial resectability status.

Keywords: conversion surgery; pancreatic cancer; resectability.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Total resection rate and status and combined vascular resection. R: resectable, BR: borderline resectable, UR: unresectable, PVR: portal/superior mesenteric vein resection, PVAR: both portal/superior mesenteric vein and arterial resection.
Figure 2
Figure 2
Overall survival classified by resectability in resection cases. The curve for the patient groups in which R—resectable, BR—borderline resectable with surgery, and UR—unresectable with surgery significantly differed from that for the BR and UR groups without surgery (p < 0.0001).
Figure 3
Figure 3
Relapse-free-survival classified by resectability in resection cases. The curve for the patient group in which R—resectable was not significantly different from that for the patient groups BR—borderline resectable with surgery and UR—unresectable with surgery (p = 0.249).
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