| Purpose. This study aimed to evaluate the optimal duration of neoadjuvant chemotherapy (NAC) for patients with borderline resectable pancreatic cancer (BRPC). Methods. Medical records of BRPC patients who received NAC prior to intended curative resection were reviewed retrospectively. Patient demographics, clinicopathological factors, and prognostic factors for overall survival were analyzed. Serum carbohydrate antigen (CA) 19-9 level was examined monthly during NAC. Results. A total of 118 BRPC patients were enrolled. The median survival time and 5-year overall survival were 28.0 months and 31%, respectively. Three months after NAC, normalization of CA19-9 level occurred in 57% and 92% underwent resection. Multivariate analysis showed that radiological partial response (hazard ratio (HR), 0.52; 95% confidence interval (CI), 0.26-0.98; 42), normalization of CA19-9 level after NAC (HR, 0.38; 95% CI, 0.22-0.66; ), and tumor resection (HR, 0.30; 95% CI, 0.13-0.69; 06) were independent predictors of better survival. The median CA19-9 level and the rate of CA19-9 level normalization before and after NAC were 256 U/mL (interquartile range (IQR), 2-24057) and 33%, and 27 U/mL (IQR, 2-4847) and 57%, respectively. Conclusions. The normalization of CA19-9 level after NAC was an independent predictor of better survival in BRPC patients. At least 3 months of NAC is needed. |
