Evidence map›Paper›PMID 42439926›Full record

ArticleSurgery today2026

Preoperative predictors of early recurrence after neoadjuvant gemcitabine plus S-1 in resectable pancreatic cancer: a multicenter study.

Yoshihiro Shirai, Ryoga Hamura, Masashi Tsunematsu, Takeshi Gocho, Taro Sakamoto, Shinji Onda, Yoshiaki Tanji, Norimitsu Okui, Michinori Matsumoto, Kenei Furukawa and 2 more

Abstract read
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Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yoshihiro ShiraiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan. shirai@jikei.ac.jp.ORCID http://orcid.org/0000-0002-4907-0101
Ryoga HamuraDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Masashi TsunematsuDepartment of Gastrointestinal Surgery, Saku General Hospital Advanced Care Center, Nagano, Japan.
Takeshi GochoDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Taro SakamotoDepartment of Surgery, The Jikei University West Medical Center, Tokyo, Japan.
Shinji OndaDepartment of Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan.
Yoshiaki TanjiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Norimitsu OkuiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Michinori MatsumotoDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Kenei FurukawaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Koichiro HarukiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Toru IkegamiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.

Funding

Japan Society for the Promotion of Science 23K08202Japan Society for the Promotion of Science 26K11655
6 · The paper itself

Abstract

purposePancreatic ductal adenocarcinoma (PDAC) frequently recurs early after resection, resulting in a poor prognosis. Although neoadjuvant chemotherapy with gemcitabine plus S-1 (NAC-GS) is the standard strategy in Japan, predictors of early recurrence (ER) remain unclear.

methodsWe retrospectively analyzed 102 patients with resectable pancreatic ductal adenocarcinoma (PDAC) who underwent NAC-GS followed by pancreatectomy at four institutions. ER was defined as recurrence within 6 months of surgery. Clinicopathological variables were evaluated to identify the predictors of ER.

resultsER occurred in 9% of patients and was independently associated with significantly worse overall survival. Tumor progression during NAC-GS and elevated pre-treatment CA19-9 levels (> 292 U/mL) were identified as independent preoperative predictors of ER. A novel scoring system incorporating these factors effectively stratified ER risk (ER rates: 1%, 13%, and 100% for scores of 0, 1, and 2, respectively; AUC = 0.85). The score was also associated with the long-term prognosis.

conclusionTumor progression during NAC-GS and elevated CA19-9 levels are significant predictors of ER in patients with resectable PDAC. The proposed scoring system may aid in identifying patients who could benefit from alternative or intensified treatment strategies.

Indexed as

Early recurrenceGemcitabine and S-1Neoadjuvant chemotherapyPancreatic cancerPancreatic resection

Identifiers

PMID42439926

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.