Background: S-1 in adjuvant chemotherapy (AC) administration after pancreatic cancer (PC) surgery has been standardized in Japan. The Ehime study confirmed that a postoperative higher C-reactive protein-to-albumin ratio (CAR) value predicted the risk of adverse event (AE)-related S-1 non-completion as an AC in patients with PC after curative surgery. This study aimed to investigate the index to predict S-1 tolerance among patients who underwent curative surgery for PC (the Dokkyo study). Methods: This retrospective validation cohort study included 172 patients at the Department of Hepato-Biliary Pancreatic Surgery, Dokkyo Medical University, Japan, from January 2010 to December 2022. All patients underwent nutritional screening using the postoperative CAR. S-1 completion status and its effect on prognosis were systematically followed up and investigated. We conducted a statistical analysis of predictive markers to investigate their association with S-1 completion. Results: Patients were categorized into the S-1 completion (N = 91) and non-completion (N = 81) groups. The S-1 completion group demonstrated a significantly lower CAR than the S1 non-completion group. Moreover, the current study revealed a significant difference in the S-1 completion rate, applying the CAR cutoff value of 0.05 established in the Ehime study. Additionally, univariate and multivariate analyses confirmed that a CAR of <0.05 was significantly associated with S-1 completion. Conclusions: The Dokkyo study confirmed the results observed in the Ehime study. Consequently, an increased postoperative CAR value appeared as a universal applicable marker for the risk factor of AE-related S-1 non-completion after curative surgery for patients with PC.
背景：在日本，胰腺癌术后辅助化疗中S-1的应用已形成标准化方案。爱媛研究证实，术后较高的C反应蛋白-白蛋白比值可作为预测胰腺癌根治术后患者因不良事件导致辅助化疗中S-1治疗中断风险的指标。本研究旨在探索预测胰腺癌根治术后患者S-1耐受性的相关指标（独协医学研究）。方法：本回顾性验证队列研究纳入2010年1月至2022年12月期间日本独协医科大学肝胆胰外科收治的172例患者。所有患者均接受术后CAR值的营养筛查，并系统随访S-1治疗完成情况及其对预后的影响。通过统计学分析探究预测标志物与S-1治疗完成度的关联性。结果：患者分为S-1完成组（91例）与未完成组（81例）。完成组的CAR值显著低于未完成组。应用爱媛研究设定的CAR临界值0.05进行分析，两组间S-1完成率存在显著差异。单因素与多因素分析均证实CAR<0.05与S-1治疗完成显著相关。结论：独协医学研究验证了爱媛研究的发现。术后CAR值升高可作为预测胰腺癌根治术后患者因不良事件导致S-1治疗中断风险的普适性标志物。
肿瘤(癌症)患者之家