New study suggests way to predict outcomes with high accuracy prior to surgery for pancreaticcancer patients
). This cohort comprised 117 men and 85 women, with a mean [SD] age of 64.7 [9.8] years at surgery. All patients received either mFOLFIRINOX or gemcitabine/nab-paclitaxel as first-line neoadjuvant chemotherapy, with 94 undergoing chemotherapy switch and the majority undergoing preoperative chemoradiation post-NAT. There were 135 patients with an elevated CA 19-9 level at diagnosis, 46 with normal levels, and 21 nonsecretors.
All patients had at least 1 FDG-PET scan post-NAT and pre-resection, and 182 had ≥2 FDG-PETs during NAT. The specific FDG-PET modality was either PET/CT or PET/MRI . We found that 122 patients had FDG-PET at baseline with a mean [SD] standardized uptake value of 6.5 [2.4], and only 4 patients had treatment-naïve nonavid tumors. Among the 122 patients who had FDG-PET at baseline pre-NAT, 34 also had avid regional lymph node involvement.
Vascular resection was required in 134 patients. The margin-positive rate was 3%, with 42 patients having metastatic lymph nodes. Lymphovascular and perineural invasion were present in 21 and 76 specimens, respectively. Pathologic treatment response categories included complete response in 27 patients, near-complete response in 50 , partial response in 108 , and no response in 17 , with a total of 77 patients having major pathologic responses.
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