イズモ　ワタル   Izumo Wataru   出雲　渉    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Evaluation of the significance of adjuvant chemotherapy in patients with stage ⅠA pancreatic ductal adenocarcinoma.
掲載誌名	正式名：Pancreatology 略　 称：Pancreatology ISSNコード：14243911/14243903
掲載区分	国外
巻・号・頁	21(3),pp.581-588
著者・共著者	IZUMO Wataru†, HIGUCHI Ryota*, FURUKAWA Toru, YAZAWA Takehisa, UEMURA Shuichiro, MATSUNAGA Yutaro, SHIIHARA Masahiro, YAMAMOTO Masakazu
担当区分	筆頭著者
発行年月	2021/04
概要	BACKGROUND:Although adjuvant chemotherapy is considered a standard treatment for resected pancreatic ductal adenocarcinoma (PDAC), its utility in stage ⅠA patients is unclear. We aimed to investigate the recurrence rate, surgical outcome, prognostic factors, effectiveness of adjuvant chemotherapy, and determination of groups in whom adjuvant chemotherapy is effective in patients with stage ⅠA PDAC.METHODS:We retrospectively analyzed 73 patients who underwent pancreatectomy and were pathologically diagnosed with stage ⅠA PDAC between 2000 and 2018. We evaluated the relation between clinicopathological factors, recurrence rates, and outcomes such as the recurrence-free and disease-specific survival rates (RFS and DSS, respectively).RESULTS:The 5-year RFS and DSS rates were 52% and 58%, respectively. In multivariate analysis, a platelet-to-lymphocyte ratio (PLR) ≥ 170, prognostic nutrition index (PNI) < 47.5, and pathological grade 2 or 3 constituted risk factors for a shorter DSS (hazard ratios: 4.7, 4.6, and 4.1, respectively). Patients with 0-1 of these risk factors (low-risk group; n = 47) had significantly higher 5-year DSS rates than those with 2-3 risk factors (high-risk group; n = 26) (80% vs. 23%; P < 0.001). Patients in the low-risk group showed similar 5-year RFS rates regardless of whether they received or not adjuvant chemotherapy (75% vs 70%, respectively; P = 0.49). Contrarily, high-risk patients who underwent adjuvant chemotherapy had higher 5-year RFS rates than those who did not receive adjuvant chemotherapy (32% vs 0%; P = 0.045).CONCLUSIONS:In stage IA PDAC, adjuvant chemotherapy seems to be effective only in a subgroup of high-risk patients.
DOI	10.1016/j.pan.2021.01.024
PMID	33579600