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Correlation between Angiotensin Inhibitor Administration and Longer Survival in Patients Who Underwent Curative Resection for Pancreatic Cancer

 Hye Yeon Yang  ;  Min Yu Kang  ;  Chang Moo Kang  ;  Woo Jung Lee  ;  Ho Kyoung Hwang 
 YONSEI MEDICAL JOURNAL, Vol.65(6) : 324-331, 2024-06 
Journal Title
Issue Date
Adult ; Aged ; Angiotensin-Converting Enzyme Inhibitors / therapeutic use ; Carcinoma, Pancreatic Ductal* / drug therapy ; Carcinoma, Pancreatic Ductal* / mortality ; Carcinoma, Pancreatic Ductal* / pathology ; Carcinoma, Pancreatic Ductal* / surgery ; Disease-Free Survival ; Female ; Humans ; Hypertension / drug therapy ; Male ; Middle Aged ; Pancreatic Neoplasms* / drug therapy ; Pancreatic Neoplasms* / mortality ; Pancreatic Neoplasms* / pathology ; Pancreatic Neoplasms* / surgery ; Retrospective Studies
Angiotensin system inhibitor ; ductal adenocarcinoma ; pancreatic cancer ; survival
Purpose: The microenvironment of pancreatic ductal adenocarcinoma (PDAC) with extensive desmoplastic stroma contributes to aggressive cancer behavior. Angiotensin system inhibitors (ASIs) reduce stromal fibrosis and are a promising therapeutic strategy. The purpose of this study was to examine how ASIs affected the oncological results of patients who had their PDAC removed.

Materials and Methods: A retrospective assessment was conducted on the clinicopathological and survival data of patients who received curative resection for PDAC at Severance Hospital between January 2012 and December 2019.

Results: A total of 410 participants (228 male and 182 female), with a median follow-up period of 12.8 months, were included in this study. Patients were divided into three groups, based on ASI use and history of hypertension: group 1, normotensive and never used ASI (n=210, 51.2%); group 2, ASI non-users with hypertension (n=50, 12.2%); and group 3, ASI users with hypertension (n=150, 36.6%). The three groups did not differ significantly in terms of age, sex, kind of operation, T and N stages, or adjuvant and neoadjuvant therapy. Moreover, there was no discernible difference in disease-free survival between those who used ASI and those who did not (p=0.636). The 5-year overall survival (OS) rates in groups 1, 2, and 3 were 52.6%, 32.3%, and 38.0%, respectively. However, the OS rate of ASI users was remarkably higher than that of non-users (p=0.016).

Conclusion: In patients with resected PDAC, ASI is linked to longer survival rates. Furthermore, for individuals with hypertension, ASI in conjunction with conventional chemotherapy may be an easy and successful treatment option.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Minyu(강민유)
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Yang, Hye Yeon(양혜연) ORCID logo https://orcid.org/0000-0002-7831-2341
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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