Perineural invasion and lymph node involvement as indicators of surgical outcome and pattern of recurrence in the setting of preoperative XXXX -based chemoradiation therapy for resectable pancreatic cancer.

@entity1 @entity66 @entity5 @entity8982 @entity136
OBJECTIVE: To analyze the histopathological indicators significantly associated with surgical outcome and the pattern of recurrence in the setting of preoperative @entity136 -based chemoradiation therapy (CRT) and subsequent pancreatectomy. BACKGROUND: Clinicopathological assessment of the resected specimen is an indispensable tool for predicting @entity1 prognosis and localizing high-risk sites for @entity5 relapse. This procedure is also essential for the establishment of efficient postoperative follow-up protocols in the setting of a preoperative CRT strategy. METHODS: In a prospective phase II clinical trial at our hospital, 110 @entity1 received preoperative CRT and subsequent resection. All 110 resected cases were included in this study. We employed @entity66 ( @entity66 ) as a surgical outcome, and the pattern of recurrence was divided into 2 categories: (1) recurrence in the abdominal cavity (RAC), defined as either a locoregional or a peritoneal recurrence; or (2) distant recurrence (DR), defined as @entity5 recurrence in a distant organ. Clinicopathological variables were analyzed in association with @entity66 , RAC, and DR. RESULTS: Positive nodal involvement and perineural invasion were independent factors that were significantly associated with an unfavorable @entity66 (P = 0.021 and P = 0.026, respectively). The presence of perineural invasion was the single independent variable significantly associated with an increased risk of RAC (P = 0.002), whereas the status of nodal involvement was the single independent variable significantly associated with an increased risk of DR (P = 0.013). CONCLUSIONS: The status of nodal involvement and perineural invasion in resected specimens are significantly associated with @entity66 and clearly predict the pattern of recurrence in the setting of a preoperative @entity136 -based CRT strategy. This study is registered at @entity8982 and carries the ID number UMIN000001804.
