Background/Objectives: Treatment of borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer involves neoadjuvant chemotherapy followed by complex surgery, posing significant risks of toxicity, complications, and changes in quality of life (QoL). This study aims to investigate the impact of neoadjuvant chemotherapy followed by resection on overall survival (OS) and QoL.Methods: Consecutive patients with BRPC and LAPC included in a population-based study (NORPACT-2) from January 2018 to December 2020 were reviewed.Results: A total of 54 patients (BRPC; n = 43, LAPC; n = 11) underwent neoadjuvant chemotherapy followed by pancreatectomy. The majority (66.7%) received (m)FOLFIRINOX. Forty-six (85.2%) patients underwent pancreatoduodenectomy. Vascular resection was performed in 32 (59.3%) patients. Fourteen (25.9%) patients experienced major complications. The majority of the resected specimens demonstrated T2 (63%), N+ (79.6%), and R1 (85.2%) status. Median OS was 31 (CI 24.7–37.3) months. In multivariate analysis, only CAP 3 (p= 0.035) predicted worse survival. Forty (74.1%) patients experienced recurrence. Global QoL (p= 0.031), social and role functioning (p= 0.024,p= 0.031), improved three months after surgery. Pain (p= 0.042), dyspnea (p= 0.004), appetite loss (p= 0.028), and diarrhea (p= 0.007) improved post-resection.Conclusions: Patients with BRPC and LAPC undergoing neoadjuvant chemotherapy and resection have survival comparable to primary resectable pancreatic cancer. Postoperative morbidity was acceptable, and QoL recovered post-surgery. CAP grade was the only independent negative prognostic factor.
背景/目的：交界可切除胰腺癌（BRPC）和局部进展期胰腺癌（LAPC）的治疗通常包括新辅助化疗后进行复杂手术，这一过程伴随着显著的毒性风险、并发症以及生活质量（QoL）的变化。本研究旨在探讨新辅助化疗联合手术切除对患者总生存期（OS）及生活质量的影响。 方法：回顾性分析了2018年1月至2020年12月期间纳入一项基于人群的研究（NORPACT-2）的连续BRPC和LAPC患者。 结果：共有54例患者（BRPC：43例，LAPC：11例）接受了新辅助化疗后行胰腺切除术。大多数患者（66.7%）接受了（改良）FOLFIRINOX方案化疗。46例（85.2%）患者接受了胰十二指肠切除术。32例（59.3%）患者进行了血管切除。14例（25.9%）患者出现了主要并发症。大部分切除标本的病理分期为T2（63%）、淋巴结阳性（N+，79.6%）和切缘阳性（R1，85.2%）。中位总生存期为31个月（95% CI：24.7–37.3）。在多变量分析中，仅CAP分级为3级（p=0.035）是生存期较差的预测因素。40例（74.1%）患者出现复发。术后三个月，总体生活质量（p=0.031）、社会功能和角色功能（p=0.024，p=0.031）均得到改善。术后疼痛（p=0.042）、呼吸困难（p=0.004）、食欲减退（p=0.028）和腹泻（p=0.007）等症状亦有所改善。 结论：接受新辅助化疗和手术切除的BRPC和LAPC患者，其生存期与初始可切除胰腺癌患者相当。术后并发症发生率可接受，生活质量在术后得以恢复。CAP分级是唯一独立的负面预后因素。
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