ヒグチ　リヨウタ   Higuchi Riyouta   樋口　亮太    所属   医学部 医学科（附属八千代医療センター）    職種   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	Standard versus delayed initiation of S-1 adjuvant chemotherapy after surgery for pancreatic cancer: a secondary analysis of a nationwide cohort by the Japan Pancreas Society
掲載誌名	正式名：Journal of gastroenterology 略　 称：J Gastroenterol ISSNコード：14355922/09441174
掲載区分	国外
巻・号・頁	58(8),pp.790-799
著者・共著者	TOMIMARU Yoshito,EGUCHI Hidetoshi,SHOMOMURA Yoshimitsu,KITAMURA Tetsuhisa,INOUE Yosuke,NAGAKAWA Yuichi,OHBA Akihiro,ONOE Shunsuke,UNNO Michiaki,HASHIMOTO Daisuke,KAWAKATSU Shoji,HAYASHI Tsuyoshi,HIGUCHI Ryota,KITAGAWA Hirohisa,UEMURA Kenichiro,KIMURA Yasutoshi,SATOI Sohei,TAKAYAMA Yoshifumi, Committee of Clinical Research, Japan Pancreas Society
発行年月	2023/08
概要	BACKGROUND:Based on the Japan Adjuvant Study Group of Pancreatic Cancer-01 results, S-1 adjuvant chemotherapy has been the standard in resected pancreatic ductal adenocarcinoma (PDAC) patients in Japan and elsewhere, initiated within 10 weeks after surgery. To assess the clinical impact of this timing, we conducted a secondary analysis of a nationwide survey by the Japan Pancreas Society.METHODS:A total of 3361 patients were divided into two groups: 2681 (79.8%) initiating the therapy within 10 weeks after surgery (standard) and 680 (20.2%) after 10 weeks (delayed). We compared recurrence-free survival (RFS) and overall survival (OS) using the log-rank test and Cox proportional hazards model with conditional landmark analysis between the groups. Results were verified by adjustment with inverse-probability-of-treatment weighting (IPTW) analysis.RESULTS:The median timing of S-1 adjuvant chemotherapy initiation was 50 days (interquartile range: 38-66). In the standard group, 5-year RFS and OS rates were 32.3-48.7%, respectively, compared with 25.0-38.7% in the delayed group. Hazard ratios (HRs) and 95% confidence intervals were 0.84 (0.76-0.93) for RFS (p < 0.001) and 0.77 (0.69-0.87) for OS (p < 0.001). The IPTW analysis yielded 5-year RFS rates of 32.1% and 25.3% in the standard versus delayed group, respectively [HR = 0.86 (0.77-0.96), p < 0.001] and 5-year OS rates of 48.3% and 39.8%, respectively [HR = 0.81 (0.71-0.92), p < 0.001].CONCLUSIONS:Initiation of S-1 adjuvant chemotherapy in resected PDAC patients within 10 weeks after surgery may offer survival benefit over later initiation.
DOI	10.1007/s00535-023-01988-7
PMID	37329351