The role of natural killer cell activity as a milestone in oncologic outcome after curative resection of pancreatic adenocarcinoma

J Surg Oncol. 2023 Dec;128(8):1353-1364. doi: 10.1002/jso.27432. Epub 2023 Aug 31.

Abstract

Background: The objective of this study was to investigate differences in oncologic outcomes of patients with pancreas cancer according to natural killer cell activity (NKA).

Methods: A total of 118 patients who underwent curative resection for primary pancreas cancer in two hospitals were analyzed. NKA change pattern was analyzed. Difference in disease-free survival or overall survival was investigated by dividing subjects into two groups based on a normal NKA value for each period.

Results: NKA value decreased after surgery compared to the value measured at admission. It recovered to normal levels at 5 weeks postoperatively. The low NKA (less than 250 pg/mL) group at admission, 5 weeks postoperatively, and before 1st chemotherapy had significantly poorer disease-free survival than the normal NKA group. In multivariate analysis, NKA values less than 250 pg/mL at admission (odds ratio = 2.267, p = 0.023) and N 1 or N2 category (odds ratio = 2.478, p = 0.023) were significant factors associated with recurrence after curative resection.

Conclusions: NKA in patients with pancreatic cancer demonstrated noticeable changes after surgery. Immunologically predisposed patients with a low NKA value had a high risk of early recurrence and a poor prognosis, although pancreatic cancer was surgically removed.

Keywords: disease-free survival; immunologic surveillance; killer cells; natural; pancreatic carcinoma; surgery.

MeSH terms

  • Adenocarcinoma* / surgery
  • Disease-Free Survival
  • Humans
  • Killer Cells, Natural
  • Pancreatic Neoplasms* / pathology
  • Prognosis
  • Retrospective Studies