An evaluation of adjuvant chemotherapy following neoadjuvant chemotherapy and resection for borderline resectable and locally advanced pancreatic cancer - 20/06/22
Abstract |
Background |
In borderline resectable and locally advanced (BRLA) pancreatic cancer patients, the role of adjuvant therapy (AT) after neoadjuvant therapy (NAT) and curative-intent resection is poorly understood.
Methods |
Using the National Cancer Database (NCDB) between 2011 and 2017, we identified BRLA patients who received NAT and resection. Kaplan-Meier analysis and multivariable Cox proportional hazards (PH) regression were performed to examine the association between AT and overall survival (OS).
Results |
Of 17,905 BRLA patients identified, 764 received NAT and resection, of which 203 received AT. Median age was 63 years, and 53.1% were female. Kaplan Meier analysis revealed no differences in median OS between AT vs non-AT groups (28.9 vs 30.1months, p = 0.498). In the multivariable Cox PH model, after adjusting for other factors, when margin was positive, AT was associated with an improved survival (HR 0.54, 95%CI 0.32–0.90, p = 0.031).
Conclusion |
AT was not associated with survival in BRLA patients who received NAT and resection except in patients with positive margins. Further research is necessary to better understand the role of AT following NAT in patients with BRLA.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Evidence evaluating adjuvant therapy (AT) after neoadjuvant therapy (NAT) and resection for BRLA pancreatic cancer is sparse. |
• | AT is not associated with survival after NAT and resection for BRLA. |
• | AT is associated with prolonged survival in patients with positive margins. |
• | AT is not associated with survival in patients with positive nodes. |
Keywords : Adjuvant chemotherapy, Borderline resectable, Locally advanced, Pancreatic cancer, Pancreatic surgery
Plan
Vol 224 - N° 1PA
P. 51-57 - juillet 2022 Retour au numéro
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