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開催概要
開催回
第58回・2020年・京都
 

膵癌Conversion手術適応における術前スコアリングシステムの応用

演題番号 : WS20-6

[筆頭演者]
岡田 健一:1 
[共同演者]
川井 学:1、廣野 誠子:1、宮澤 基樹:1、北畑 裕司:1、小林 良平:1、上野 昌樹:1、速水 晋也:1、宮本 篤:1、山上 裕機:1

1:和歌山県立医科大学・第二外科

 

Purpose: The aim of this study is to investigate the feasibility of integrated scoring system of prognostic parameters using the data before and after neoadjuvant therapy in patients with PDAC registered in the prospective phase II study.
Methods: We determined six favorable parameters as follows; as four systemic weighted factors, the value of CA19-9 less than 100 U/ml prior to neoadjuvant therapy, the presence of normal post-treatment value of CA 19-9, SUV-max value of FDG PET/CT less than 6.0 prior to neoadjuvant therapy, the presence of the reduction index of post/pre-treatment SUV-max value more than 50.0%, and as two local weighted factors, pre-treatment whole tumor ADC value more than 1.20x10-3 mm2/s, and post-treatment whole tumor ADC value more than 1.40x10-3 mm2/s. The collected data was assessed as favorable or non-favorable, and favorable factors were counted as one point, finally integrated evaluated in total point zero to six. The integrated point equal to and more than 4 was categorized to high score group, and less than 4 to low score group.
Results: The analysis about single prognostic analyses demonstrated that SUV-max regression index is the only significant predictor for recurrence free survival (RFS) and so as whole tumor ADC value after neoadjuvant therapy for overall survival (OS). OS and RFS in the patients was greater in patients with high score (n=11) than with low score (n=18; log-rank test P=0.03/0.028).
Conclusions: It is feasible to predict OS and RFS with the integrated scoring system using current prognostic indexes before/after neoadjuvant therapy for PDAC. The patients with high score shows favorable survival compared to those with low score. We introduce our current strategy for conversion surgery of pancreatic cancer.

キーワード

臓器別:膵臓

手法別:手術療法

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