Predictive factors of survival in patients with borderline resectable pancreatic cancer who received neoadjuvant therapy

Pancreatology. 2021 Dec;21(8):1451-1459. doi: 10.1016/j.pan.2021.08.009. Epub 2021 Aug 24.

Abstract

Background/objectives: This study aimed to develop the prognostic score (PS) based on clinical factors to stratify the prognosis in borderline resectable pancreatic cancer (BRPC) patients treated with neoadjuvant therapy (NAT).

Methods: This retrospective study included 57 BRPC patients who received NAT between April 2012 and December 2017. A score was assigned to each prognostic factor available before and after NAT, according to their β coefficients.

Results: Multivariate analysis identified the following six prognostic factors, and scores were assigned as follows: being a familial PC patient (HR 4.98, p = 0.029), post-NAT CA19-9 ≥37 U/ml (HR 3.08, p = 0.020), reduction rate of CA19-9 <70% (HR 3.71, p = 0.008), pre-NAT neutrophil-to-lymphocyte ratio ≥2.8 (HR 4.32, p = 0.003), and non-resection (HR 3.98, p = 0.009) were scored as 1; and post-NAT albumin-to-globulin ratio <1.33 (HR 8.31, p < 0.001) was scored as 2. The PS was calculated by summing the scores assigned to each prognostic factor. Patients were then classified into three risk groups (low- [0-1 points], moderate- [2-3 points], and high-risk [4-6 points] groups). Median overall survival in the low-, moderate-, and high-risk groups were not reached, 37.5 months, and 11.8 months, respectively, and there were significant differences in survival among the three groups (p < 0.01 in each group).

Conclusions: This study showed that the PS may be useful for predicting the prognosis of BRPC patients treated with NAT.

Keywords: Chemotherapy; Familial pancreatic cancer; Pancreatic ductal adenocarcinoma; Prognostic factor; Surgery.

MeSH terms

  • CA-19-9 Antigen
  • Humans
  • Neoadjuvant Therapy*
  • Pancreatectomy
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / surgery
  • Prognosis
  • Retrospective Studies
  • Survival Rate

Substances

  • CA-19-9 Antigen