| Popis: |
Background/Objectives: Neoadjuvant therapy is commonly used for invasive pancreatic ductal carcinoma (PDAC). Tumor budding and high podoplanin expression in cancer-associated fibroblasts (CAFs) are prognostic factors in patients with various carcinomas, including PDAC, who have not received neoadjuvant therapy. In this study, we investigated whether tumor budding and podoplanin-positive CAFs are associated with outcomes in Japanese PDAC patients with neoadjuvant therapy. Methods: Histopathological findings of surgically resected PDACs with neoadjuvant therapy were reviewed (2005–2018; n=97). In accordance with International Tumor Budding Consensus Conference recommendations, tumors were evaluated for budding at 20× magnification (/0.785 mm2), and at 40× magnification (/0.237 mm2; mean number of fields: 3) for podoplanin expression in CAFs (%). Disease-specific survival (DSS) and disease-free survival were analyzed using the log-rank test and Cox proportional hazards model. Results: After adjusting for T category, N category, resection margin, and adjuvant therapy, multivariate analysis showed tumor budding at 40× magnification was an independent prognostic factor for worse DSS (hazard ratio: 2.41, p=0.022). Tumor budding at 20× magnification and podoplanin-positive CAFs tended to be associated with worse DSS; however, these were not statistically significant. Conclusions: Our findings indicate that tumor budding is an independent prognostic factor in PDAC patients with neoadjuvant therapy. |
