| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Clinicopathological Factors on Survival after Conversion Surgery for Unresectable Locally Advanced Pancreatic Cancer: A Nationwide Study by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. |
| 掲載誌名 | 正式名：Annals of surgery 略 称：Ann Surg ISSNコード：15281140/00034932 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Satoshi Yasuda, Sohei Satoi, Hideki Takami, Satoshi Hirano, Hirofumi Akita, Yu Takahashi, Yuta Yoshida, Michiaki Unno, Riki Ninomiya, Manabu Kawai, Yuichi Nagakawa, Teiichi Sugiura, Naoto Yamamoto, Minako Nagai, Kenichiro Uemura, Masafumi Imamura, Naoki Ozu, Masafumi Nakamura, Masayuki Otsuka, Masayuki Sho |
| 発行年月 | 2026/01 |
| 概要 | OBJECTIVE:To identify prognostic factors, including preoperative treatment duration, among patients who underwent conversion surgery (CS) for unresectable locally advanced pancreatic cancer (UR-LAPC).BACKGROUND:While CS has been increasingly adopted for UR-LAPC, optimal perioperative strategies remain controversial.METHODS:This multicenter study included 465 UR-LAPC patients who underwent CS following preoperative chemotherapy with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP) from 2015 to 2020 at 84 Japanese institutions.RESULTS:Median overall survival (OS) from treatment initiation was 43.8 months with a 5-year survival rate of 37.2%. A prognostic cutoff for preoperative treatment duration was identified at 6.1 months using maximally selected rank statistics. Patients receiving >6 months of preoperative treatment (n=350) demonstrated significantly better OS (50.4 vs. 29.7 mo) and recurrence-free survival (RFS) (15.6 vs. 9.1 mo) compared with those receiving ≤6 months (n=115, both P<0.001). Multivariate analysis identified four independent preoperative prognostic factors: treatment duration >6 months, FFX-based regimens, normal tumor markers (CA19-9 and CEA), and a prognostic nutritional index ≥45 before CS. These four preoperative factors enabled clear prognostic stratification: patients with ≥3 factors showed significantly improved survival compared with those with ≤2 factors (HR 0.44, P<0.0001; 5-year OS: 59.8% vs. 26.3%).CONCLUSIONS:The combination of four preoperative prognostic factors may enable risk stratification among patients undergoing CS for UR-LAPC. These findings may help inform treatment sequencing and patient selection, although external validation is needed to confirm their generalizability. |
| DOI | 10.1097/SLA.0000000000007012 |
| PMID | 41559871 |