Original ArticlesA Therapeutic Strategy for Resectable Pancreatic Cancer Based on Risk Factors of Early RecurrenceKurahara, Hiroshi MD, PhD*; Maemura, Kosei MD, PhD*; Mataki, Yuko MD, PhD*; Sakoda, Masahiko MD, PhD*; Iino, Satoshi MD, PhD*; Kawasaki, Yota MD, PhD*; Arigami, Takaaki MD, PhD*; Mori, Shinichiro MD, PhD*; Kijima, Yuko MD, PhD*; Ueno, Shinichi MD, PhD†; Shinchi, Hiroyuki MD, PhD‡; Natsugoe, Shoji MD, PhD*Author Information From the *Departments of Digestive Surgery, Breast and Thyroid Surgery, †Clinical Oncology, ‡Health Sciences, Kagoshima University, Kagoshima, Japan. Received for publication June 17, 2017; accepted April 10, 2018. Address correspondence to: Hiroshi Kurahara, MD, PhD, Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan (e-mail: email@example.com). The authors declare no conflict of interest. Pancreas: July 2018 - Volume 47 - Issue 6 - p 753-758 doi: 10.1097/MPA.0000000000001066 Buy Metrics Abstract Objectives The aim of this study was to identify risk factors for early recurrence and assess the prognostic benefit of neoadjuvant therapy (NAT) for resectable pancreatic cancer. Methods Patients with radiographically resectable pancreatic cancer according to the National Comprehensive Cancer Network guidelines were enrolled. We regarded recurrence within 6 months after surgery as early recurrence. Results This study involved 115 patients (80 who underwent upfront surgery and 35 who received NAT). Serum carbohydrate antigen 19-9 greater than 85 U/mL and p53 expression in 0 or more than 80% of tumor cells were independent risk factors for early recurrence after upfront surgery. We classified patients into a high-risk group (1 or 2 risk factors) and a low-risk group (no risk factors). In the high-risk group, the median overall survival time of patients with NAT was significantly longer than that of patients without NAT (P = 0.028). By contrast, the median overall survival time was not different according to NAT in the low-risk group. Conclusions Serum carbohydrate antigen 19-9 and p53 expression of the primary tumor could be predictors of early recurrence in patients with resectable pancreatic cancer. The prognosis of patients with a high risk of early recurrence may be improved using NAT. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.