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 Survival Impact of Pathological Residual Patterns for Pancreatic Ductal Adenocarcinoma After Neoadjuvant Therapy.
掲載誌名 正式名:Journal of hepato-biliary-pancreatic sciences
略  称:J Hepatobiliary Pancreat Sci
ISSNコード:18686982/18686974
掲載区分国外
巻・号・頁 pp.Online ahead of print
著者・共著者 Hidetaka Miyazaki, Mitsuaki Ishida, So Yamaki, Nguyen Thanh Sang, Kazuki Matsumura, Hiroyuki Ishida, Yuki Matsui, Katsunori Uchida, Daisuke Hashimoto, Sohei Satoi
発行年月 2026/06
概要 BACKGROUND:With increasing use of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC), accurate pathological response system is essential. Although the College of American Pathologists (CAP) grading is widely used, its prognostic utility remains limited.METHODS:This retrospective study included 206 patients with resectable or borderline resectable PDAC who underwent pancreatectomy following NAT. Pathological residual patterns were morphologically classified into three categories-type I (concentric distribution of residual tumor without any surrounding lesions), type II (concentric distribution with surrounding lesions), type III (residual multinodular lesions)-with types I, II grouped as the concentric type, and types III as the multinodular type.RESULTS:The concentric type had significantly longer median overall survival (OS: 133 vs. 32 months) and disease-free survival (DFS: 32 vs. 18 months) compared with the multinodular type (both p < 0.001). Residual patterns was an independent prognostic factor for OS (HR: 2.62, p = 0.017), whereas CAP grading was not (p = 0.142). Residual patterns also provided superior prognostic discrimination, with higher Harrell's C-index for OS than CAP grading (0.711 vs. 0.595; p = 0.047).CONCLUSION:Pathological residual patterns may serve as a practical prognostic indicator after NAT.
DOI 10.1002/jhbp.70146
PMID 42348279