胰腺导管腺癌新辅助治疗后病理完全缓解的情况很少见。与其他恶性肿瘤类似，胰腺导管腺癌实现病理完全缓解似乎与提高生存率相关。然而，由于此类事件的罕见性，胰腺癌病理完全缓解的真正意义仍不清楚。本研究的目的是调查病理完全缓解对生存和复发的影响。在一项单中心回顾性研究中，病理完全缓解被定义为完全按照严格方案取样的切除标本中没有证据表明存在存活的肿瘤细胞并且其中发现了残留的肿瘤床。通过手术测量疾病特异性生存率和无病生存率。检查了疾病特异性生存率和无病生存率的独立预测因子。总共纳入了 403 名患者。单纯化疗后，15 名患者 (3.8%) 出现病理完全缓解。中位随访 42 个月 (95% CI 38-45) 后，病理完全缓解患者的 3 年疾病特异性生存率为 87%，而病理完全缓解患者的 3 年疾病特异性生存率为 43% (P = .014)。病理完全缓解组的复发率为 40% (n = 6/15)，而病理完全缓解组的复发率为 69.8% (n = 271/388)。与无病理完全缓解组相比，病理完全缓解组的无病生存期更长，1 年和 3 年率更高（分别为 80% vs 60% 和 48% vs 24%）。研究发现，病理完全缓解是疾病特异性生存 (P = .035) 的独立保护因素，但不是无病生存 (P = .052)。胰腺导管腺癌的病理完全缓解并不等于治愈，而是确保治愈延长生存期。尽管如此，复发仍然是一个重大问题，即使在这些特殊的反应者中，复发率也很高。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Pathologic complete response after neoadjuvant treatment in pancreatic ductal adenocarcinoma is a rare occurrence. Similar to other malignancies, achieving a pathologic complete response in pancreatic ductal adenocarcinoma seems to correlate with improved survival. However, because of the rarity of such events, the true significance of pathologic complete response in pancreatic cancer remains unclear. The aim of the present study was to investigate the impact of pathologic complete response on survival and recurrence.In a single-center retrospective study, pathologic complete response was defined as no evidence of viable tumor cells in resected specimen entirely sampled according to a rigorous protocol and in which a residual tumor bed was identified. Disease-specific survival and disease-free survival were measured from surgery. Independent predictors for disease-specific survival and disease-free survival were examined.Overall, 403 patients were included. Pathologic complete response was found in 15 patients (3.8%), after chemotherapy alone. After a median follow-up of 42 months (95% CI 38-45), 3-year disease-specific survival was 87% in pathologic complete response patients vs 43% in those without pathologic complete response (P = .014). The recurrence rate was 40% (n = 6/15) in the pathologic complete response group compared with 69.8% (n = 271/388) in those without pathologic complete response. Disease-free survival was longer in the pathologic complete response group, with higher 1- and 3-year rates compared with the no-pathologic complete response group (80% vs 60% and 48% vs 24%, respectively). Pathologic complete response was found to be an independent protective factor for disease-specific survival (P = .035) but not for disease-free survival (P = .052).Pathologic complete response in pancreatic ductal adenocarcinoma is not synonymous of cure but ensure a prolonged survival. Nevertheless, recurrence remains a significant concern, with high rates observed even among these exceptional responders.Copyright © 2024 Elsevier Inc. All rights reserved.