The influence of familial pancreatic cancer on postoperative outcome in pancreatic cancer: relevance to adjuvant chemoth
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ORIGINAL ARTICLE—LIVER, PANCREAS, AND BILIARY TRACT
The influence of familial pancreatic cancer on postoperative outcome in pancreatic cancer: relevance to adjuvant chemotherapy Koji Tezuka1 • Yukiyasu Okamura1 • Teiichi Sugiura1 • Takaaki Ito1 • Yusuke Yamamoto1 • Ryo Ashida1 • Katsuhisa Ohgi1 • Katsuhiko Uesaka1
Received: 4 May 2020 / Accepted: 12 September 2020 Ó Japanese Society of Gastroenterology 2020
Abstract Background Familial pancreatic cancer (FPC) is defined as a family in which at least two first-degree relatives have pancreatic cancer (PC). The prognostic significance of PC in an FPC family after surgery is not fully understood. Methods This was a retrospective study of 427 patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma between January 2008 and December 2016. PC patients who also had at least one first-degree relative with PC were defined as FPC patients. The associations between recurrence and clinicopathological characteristics were analyzed for both FPC and non-FPC patients. Results FPC patients accounted for 31 of the 427 (7.3%) patients. Recurrence occurred in 72.1% of the total cohort and in 87.1% of the 31 FPC patients. Multivariate analysis showed that being an FPC patient was an independent predictor for relapse-free survival (RFS) (hazard ratio [HR] 1.52, P = 0.038). Although univariate analysis revealed that being an FPC patient was significantly associated with poorer overall survival (OS) (P \ 0.001), multivariate analysis showed that being an FPC patient was not an independent predictor for OS (P = 0.164). Dichotomization of the 427 patients into those who received (n = 317: 17 FPC and 300 non-FPC patients) and did not receive
(n = 110: 14 FPC and 96 non-FPC patients) adjuvant chemotherapy revealed that being an FPC patient was an independent predictor for RFS (HR 2.50, P \ 0.001) and OS (HR 2.30, P = 0.003) only for patients who received adjuvant chemotherapy. Conclusions This study has shown that being an FPC patient is a significant prognostic indicator for PC patients who undergo resection and receive adjuvant chemotherapy. Keywords Familial pancreatic cancer Family history Adjuvant chemotherapy Recurrence Survival Abbreviations PC Pancreatic cancer FPC Familial pancreatic cancer PDAC Pancreatic ductal adenocarcinoma US Ultrasonography CT Computed tomography RPC Resectable pancreatic cancer PV/SMV Portal vein and/or superior mesenteric vein BRPC Borderline resectable pancreatic cancer UICC Union for International Cancer Control RFS Relapse-free survival OS Overall survival HR Hazard ratio
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00535-020-01730-7) contains supplementary material, which is available to authorized users. & Yukiyasu Okamura [email protected] 1
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka Cancer Center Hospital, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka 411-8777, Japan
Introduction Pancreatic cancer (PC) is a highly lethal malignancy
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