Microscopic tumor mapping of post-neoadjuvant therapy pancreatic cancer specimens to predict post-surgical recurrence: A prospective cohort study

Although various pathological grading systems are available for evaluating the response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant therapy (NAT), their prognostic value has not been thoroughly validated. This study examined whether microscopic tumor mapping of post-NAT specimens could...

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Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2024-06, Vol.24 (4), p.562-571
Main Authors: Park, Yeshong, Han, Yeon Bi, Kim, Jinju, Kang, MeeYoung, Lee, Boram, Ahn, Eun Sung, Han, Saemi, Kim, Haeryoung, Na, Hee-Young, Han, Ho-Seong, Yoon, Yoo-Seok
Format: Article
Language:English
Subjects:
NAT
Neoadjuvant therapy
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Pancreatic surgery
PDAC
Tumor mapping
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Summary:Although various pathological grading systems are available for evaluating the response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant therapy (NAT), their prognostic value has not been thoroughly validated. This study examined whether microscopic tumor mapping of post-NAT specimens could predict tumor recurrence. This prospective study enrolled 52 patients who underwent pancreaticoduodenectomy after NAT for PDAC between 2019 and 2021. Microscopic mapping was performed to identify residual tumor loci within the tumor bed using 4 mm2 pixels. Patients were divided into small extent (SE; n = 26) and large extent (LE; n = 26) groups using a cutoff value of 226 mm2. The diagnostic performance for predicting tumor recurrence was evaluated using receiver operating characteristic (ROC) curves. Carbohydrate antigen 19-9 levels were normalised after NAT in more patients in the SE group (SE 21 [80.8%] vs. LE 13 [50.0%]; P = 0.041). Tumor size (P 
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2024.03.013