Potential Impact of Phellinus linteus on Adherence to Adjuvant Treatment After Curative Resection of Pancreatic Ductal Adenocarcinoma: Outcomes of a Propensity Score-Matched Analysis

Abstract

BACKGROUND: Surgical resection followed by adjuvant chemotherapy is the only therapeutic option in pancreatic cancer. However, there is limited research evaluating methods of improving adherence to adjuvant treatment after curative resection.

METHODS: From January 1995 to December 2014, 323 patients with pancreatic cancer who underwent pancreatectomy at the Severance Hospital were enrolled in this study. We retrospectively analyzed clinicopathologic factors with propensity score matching method.

RESULTS: The final study population was 217, after excluding patients undergoing neoadjuvant treatment or palliative resection, those who died within 30 days after operation, and those lost to follow-up after discharge. Among them, 161 received adjuvant treatment after curative resection. Cox's proportional hazard models revealed that nodal metastasis, perioperative transfusion, and completion of adjuvant treatment were significantly correlated with cancer recurrence and cancer-related death ( P < .05). Phellinus linteus (PL) medication was the only significant predictor for completion of adjuvant treatment after curative resection in logistic regression analysis ( P = .039). Disease-free and overall survival of the PL medication group were significantly higher than the no PL medication group ( P < .05).

CONCLUSIONS: PL medication potentially contributed to long-term oncologic outcomes by increasing patients' adherence to postoperative adjuvant chemotherapy, which resulted from PL medication associated with low toxicity of chemotherapy.