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Table 1 Neoadjuvant chemotherapy and efficacy evaluation

From: Feasibility of laparoscopic versus open pancreatoduodenectomy following neoadjuvant chemotherapy for borderline resectable pancreatic cancer: a retrospective cohort study

Variable

Number (%)/median (IQR)

Total (n=77)

OPD (n=57)

LPD (n=20)

P value

Neoadjuvant chemotherapy information

Pathological diagnosis method

   

-

 Endoscopic ultrasonography guided fine-needle biopsy

61 (79.2)

44 (77.2)

17 (85.0)

 

 Percutaneous fine needle biopsy

9 (11.7)

8 (14.0)

1 (5.0)

 

 Clinically diagnoseda

7 (9.1)

5 (8.8)

2 (10.0)

 

NACT regimens

   

0.278

 Nab-paclitaxel plus gemcitabine

67 (87.0)

51 (89.5)

16 (80.0)

 

 mFOLFIRINOX

10 (13.0)

6 (10.5)

4 (20.0)

 

NACT cycles

3 (3-4)

4 (3-4)

3 (2-3)

0.008

Time interval between the end of NACT and surgery, weeks

4.4 (3.6-6.0)

4.3 (3.4-6.0)

4.7 (3.7-6.1)

0.654

NACT side effects

   

-

 Myelosuppression

8 (10.4)

6 (10.5)

2 (10.0)

 

 Gastrointestinal reaction

7 (9.1)

6 (10.5)

1 (5.0)

 

 Mild or none side effects

62 (80.5)

45 (78.9)

17 (85.0)

 

Neoadjuvant chemotherapy efficacy evaluation

CA19-9 before NACT, U/mL

234.0 (60.0-607.0)

234.0 (56.0-590.0)

275.5 (86.7-672.5)

0.450

CA19-9 after NACT, U/mL

31.6 (16.0-128.0)

33.5 (16.0-170.0)

25.4 (16.5-98.0)

0.732

Decrease rate of CA19-9, %

70.4 (51.4-90.5)

66.9 (24.2-86.7)

85.3 (63.3-92.4)

0.042

Tumor diameter before NACT, cm

3.1 (2.4-3.6)

3.3 (2.4-3.7)

2.85 (2.4-3.6)

0.515

Tumor diameter after NACT, cm

2.5 (1.9-3.1)

2.6 (1.9-3.2)

2.2 (2.0-2.9)

0.277

Shrinkage rate of diameter, %

12.1 (6.7-31.0)

10.0 (5.9-30.0)

22.2 (11.5-32.3)

0.113

SMA/CHA invasion before NACT, yes

30 (39.0)

26 (45.6)

4 (20.0)

0.043

SMV/PV invasion before NACT, yes

60 (77.9)

45 (78.9)

15 (75.0)

0.758

Resectable status before NACT

   

0.107

 Biologically borderlineb

5 (6.5)

2 (3.5)

3 (15.0)

 

 Anatomically borderline

72 (93.5)

55 (96.5)

17 (85.0)

 

SMA/CHA invasion after NACT, yes

25 (32.5)

23 (40.4)

2 (10.0)

0.013

SMV/PV invasion after NACT, yes

50 (64.9)

38 (66.7)

12 (60.0)

0.591

Resectable status after NACT

   

0.069

 Anatomically resectable

13 (16.9)

7 (12.3)

6 (30.0)

 

 Anatomically borderline

64 (83.1)

50 (87.7)

14 (70.0)

 

RECIST status

   

-

 Partial response

23 (29.9)

15 (26.3)

8 (40.0)

 

 Stable disease

51 (66.2)

40 (70.2)

11 (55.0)

 

 Progressive diseasec

3 (3.9)

2 (3.5)

1 (5.0)

 
  1. Abbreviation: IQR interquartile range, OPD open pancreatoduodenectomy, LPD laparoscopic pancreatoduodenectomy, NACT neoadjuvant chemotherapy, SMA superior mesenteric artery, CHA common hepatic artery, SMV superior mesenteric vein, PV portal vein, RECIST response evaluation criteria in solid tumors
  2. aseven patients refused biopsy for pathological examination and were clinically diagnosed with pancreatic cancer by imaging and serological examination. Their postoperative pathological diagnosis was pancreatic ductal adenocarcinoma.
  3. banatomically resectable pancreatic cancer with serum CA19-9 level ≥ 1000 U/mL
  4. cthree patients were evaluated with progressive disease because the tumor diameter increased after NACT, they still received surgical exploration because the serum CA19-9 level decreased significantly
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World Journal of Surgical Oncology

ISSN: 1477-7819

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