國家衛生研究院 NHRI:Item 3990099045/14505

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Title:	Improved survival with neoadjuvant chemotherapy in stage III pancreatic cancer: A single institutional experience
Authors:	Ting, YL;Su, YY;Chiang, NJ;Chao, YJ;Li, YJ;Huang, CJ;Liao, TK;Su, PJ;Liu, IT;Tsai, HJ;Yen, CJ;Shan, YS;Chen, LT
Contributors:	National Institute of Cancer Research
Abstract:	Background: There is increasing evidence that neoadjuvant chemotherapy in stage III pancreatic cancer resulted in higher rate of conversion surgery and improved survival. This study aims to investigate the practice pattern and how initial treatment strategy impact the outcome of stage III pancreatic ductal adenocarcinoma (PDAC). Methods:During February 2013 to July 2020, 164 stage III PDAC patients treating at National Cheng Kung University Hospital were manually reviewed. This study is approved by the Institutional Review Board (A-ER-108-113) and followed the Declaration of Helsinki. Results:The 164 patients had a median age of 66 (range 27-84), a median albumin of 4.0 g/dl (range 2.5-5.0) and a median CA 199 of 356 U/ml (range 1.5-12000). We observed a paradigm shift with neoadjuvant chemotherapy being the major approach since 2016. The initial treatment strategy was neoadjuvant chemotherapy (NAC) in 127 patients (77.4%), upfront operation (OP) in 19 patients (11.6%) and concurrent chemotherapy (CCRT) in 18 patients (11.0%). The success rate of surgery was significantly higher in NAC group than OP and CCRT group (39% vs. 26% vs 22%). The prognosis was also significantly better in NAC group than OP and CCRT group with corresponding median overall survival (mOS) of 18.6, 9.7 and 9.0 months. For NAC group, the mOS of those with or without conversion surgery was 29.4 months and 14.5 months, respectively. The combination of S-1/leucovorin, oxaliplatin and gemcitabine (SLOG) was the most common used regimen (n=52) followed by modified FOLFIRINOX (n=22). Conclusions: Neoadjuvant chemotherapy was adapted as standard of care in our institute since 2016 and achieved a significantly higher success rate of conversion surgery and improved mOS in patients with stage III PDAC.
Date:	2022-07
Relation:	Annals of Oncology. 2022 Jul;33(Suppl. 6):S535.
Link to:	http://dx.doi.org/10.1016/j.annonc.2022.05.319
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0923-7534&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000834940400408
Appears in Collections:	[Li-Tzong Chen] Conference Papers/Meeting Abstract [Hui-Jen Tsai] Conference Papers/Meeting Abstract [Nai-Jung Chiang] Conference Papers/Meeting Abstract [Yung-Yeh Su] Conference Papers/Meeting Abstract

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