Detailed Abstract
[Oral Presentation 5 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[OP 5-5] Prognostic impact and risk factors of early recurrence after conversion surgery following neoadjuvant therapy in patients with initially unresectable pancreatic ductal adenocarcinoma
Boram LEE1 , Yoo-Seok YOON*1 , Ho-Seong HAN1 , Jai Young CHO1 , Hae Won LEE1 , MeeYoung KANG1 , Yeshong PARK1 , Eunhye LEE1 , Yeongsoo JO1
1 Department Of Surgery, Seoul National University Bundang Hospital, REPUBLIC OF KOREA
Background : Several studies reported promising results of conversion surgery following neoadjuvant therapy (NAT) for initially unresectable pancreatic ductal adenocarcinoma (PDAC). However, not a few patients experience early recurrence. This study aimed to analyze the prognosis and risk factors of early recurrence after conversion surgery following NAT for initially unresectable PDAC.
Methods : A total of 114 patients receiving NAT for initially unresectable PDAC from 2011 to 2019 were evaluated retrospectively. Early recurrence was defined as relapse within 6 months after surgery. We compared survival outcomes according to conversion surgery and early recurrence.
Results : Among 114 patients, 65 patients (57.0%) underwent resection after NAT and remaining 49 patients (43.0%) did not. In the resection group, 14 patients (21.5%) experienced early recurrence after resection. The 3-year overall survival (OS) was significantly longer in the resection group than in the non-resection group (48.5% vs. 2.0%, P<0.001), but was not statistically different between the early recurrence group and non-resection group (0% vs. 2.0%, P=0.353). In multivariate analysis, post-NAT CA 19-9 (>200 U/ml) was an independent risk factor for early recurrence after conversion surgery (Hazard ratio 7.272 (95% confidence interval 1.388-38.088), P=0.017).
Conclusions : In patients with initially unresectable PDAC, resection following NAT provides the survival benefit compared with non-resection. However, considering similar survival outcomes of early recurrence after conversion surgery compared to non-resection, the risk factors for early recurrence such as high-level of post-NAT CA 19-9 should be considered when deciding conversion surgery in patients with NAT for initially unresectable PDAC.
Methods : A total of 114 patients receiving NAT for initially unresectable PDAC from 2011 to 2019 were evaluated retrospectively. Early recurrence was defined as relapse within 6 months after surgery. We compared survival outcomes according to conversion surgery and early recurrence.
Results : Among 114 patients, 65 patients (57.0%) underwent resection after NAT and remaining 49 patients (43.0%) did not. In the resection group, 14 patients (21.5%) experienced early recurrence after resection. The 3-year overall survival (OS) was significantly longer in the resection group than in the non-resection group (48.5% vs. 2.0%, P<0.001), but was not statistically different between the early recurrence group and non-resection group (0% vs. 2.0%, P=0.353). In multivariate analysis, post-NAT CA 19-9 (>200 U/ml) was an independent risk factor for early recurrence after conversion surgery (Hazard ratio 7.272 (95% confidence interval 1.388-38.088), P=0.017).
Conclusions : In patients with initially unresectable PDAC, resection following NAT provides the survival benefit compared with non-resection. However, considering similar survival outcomes of early recurrence after conversion surgery compared to non-resection, the risk factors for early recurrence such as high-level of post-NAT CA 19-9 should be considered when deciding conversion surgery in patients with NAT for initially unresectable PDAC.
SESSION
Oral Presentation 5
Room A 3/24/2023 3:50 PM - 4:40 PM