Authors
Yoshihiro Shirai, Ryoga Hamura, Masashi Tsunematsu, Takeshi Gocho, Taro Sakamoto, Shinji Onda, Yoshiaki Tanji, Norimitsu Okui, Michinori Matsumoto, Kenei Furukawa, Koichiro Haruki, Toru Ikegami
Published in
Surgery today. Jul 13, 2026. Epub Jul 13, 2026.
Abstract
Pancreatic ductal adenocarcinoma (PDAC) frequently recurs early after resection, resulting in a poor prognosis. Although neoadjuvant chemotherapy with gemcitabine plus S-1 (NAC-GS) is the standard strategy in Japan, predictors of early recurrence (ER) remain unclear.
We retrospectively analyzed 102 patients with resectable pancreatic ductal adenocarcinoma (PDAC) who underwent NAC-GS followed by pancreatectomy at four institutions. ER was defined as recurrence within 6 months of surgery. Clinicopathological variables were evaluated to identify the predictors of ER.
ER occurred in 9% of patients and was independently associated with significantly worse overall survival. Tumor progression during NAC-GS and elevated pre-treatment CA19-9 levels (> 292 U/mL) were identified as independent preoperative predictors of ER. A novel scoring system incorporating these factors effectively stratified ER risk (ER rates: 1%, 13%, and 100% for scores of 0, 1, and 2, respectively; AUC = 0.85). The score was also associated with the long-term prognosis.
Tumor progression during NAC-GS and elevated CA19-9 levels are significant predictors of ER in patients with resectable PDAC. The proposed scoring system may aid in identifying patients who could benefit from alternative or intensified treatment strategies.
PMID:
42439926
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.
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