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Neoadjuvant chemoth...
Neoadjuvant chemotherapy versus upfront surgery for resectable pancreatic adenocarcinoma : an updated nationwide study
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- Sugawara, Toshitaka (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States; Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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- Rodriguez Franco, Salvador (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Sherman, Samantha (författare)
- Department of Surgery, Parkview Hospital Randallia, IN, Fort Wayne, United States
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- Torphy, Robert J. (författare)
- Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Colborn, Kathryn (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States; Department of Biostatistics and Informatics, University of Colorado School of Medicine, CO, Aurora, United States; Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Anschutz Medical Campus, CO, Aurora, United States
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- Franklin, Oskar, 1985- (författare)
- Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Ishida, Jun (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Grandi, Samuele (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Al-Musawi, Mohammed H. (författare)
- Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States
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- Gleisner, Ana (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States; University of Colorado Cancer Center, University of Colorado School of Medicine, CO, Aurora, United States
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- Schulick, Richard D. (författare)
- Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Anschutz Medical Campus, CO, Aurora, United States; University of Colorado Cancer Center, University of Colorado School of Medicine, CO, Aurora, United States
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- Del Chiaro, Marco (författare)
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, CO, Aurora, United States; University of Colorado Cancer Center, University of Colorado School of Medicine, CO, Aurora, United States
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(creator_code:org_t)
- Wolters Kluwer, 2024
- 2024
- Engelska.
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Ingår i: Annals of Surgery. - : Wolters Kluwer. - 0003-4932 .- 1528-1140. ; 279:2, s. 331-339
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: The objective of this study was to assess the association of survival with neoadjuvant chemotherapy (NAC) in resectable pancreatic adenocarcinoma (PDAC). BACKGROUND: The early control of potential micrometastases and patient selection using NAC has been advocated for patients with PDAC. However, the role of NAC for resectable PDAC remains unclear.METHODS: Patients with clinical T1 and T2 PDAC were identified in the National Cancer Database from 2010 to 2017. Kaplan-Meier estimates, and Cox regression models were used to compare survival. To address immortal time bias, landmark analysis was performed. Interactions between preoperative factors and NAC were investigated in subgroup analyses. A propensity score analysis was performed to compare survival between multiagent NAC and upfront surgery.RESULTS: In total, 4041 patients were treated with upfront surgery and 1,175 patients were treated with NAC (79.4% multiagent NAC, 20.6% single-agent NAC). Using a landmark time of 6 months after diagnosis, patients treated with multiagent NAC had longer median overall survival compared with upfront surgery and single-agent NAC. (35.8 vs 27.1 vs 27.4 mo). Multiagent NAC was associated with lower mortality rates compared with upfront surgery (adjusted hazard ratio, 0.77; 95% CI, 0.70-0.85), whereas single-agent NAC was not. The association of survival with multiagent NAC were consistent in analyses using the matched data sets. Interaction analysis revealed that the association between multiagent NAC and a lower mortality rate did not significantly differ across age, facility type, tumor location, CA 19-9 levels, and clinical T/N stages.CONCLUSIONS: The findings suggest that multiagent NAC followed by resection is associated with improved survival compared with upfront surgery.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- pancreatic adenocarcinoma
- resectable
- neoadjuvant chemotherapy
- multiagent
- single-agent
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Sugawara, Toshit ...
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Rodriguez Franco ...
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Sherman, Samanth ...
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Torphy, Robert J ...
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Colborn, Kathryn
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Franklin, Oskar, ...
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Ishida, Jun
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Grandi, Samuele
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Al-Musawi, Moham ...
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Gleisner, Ana
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Schulick, Richar ...
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Del Chiaro, Marc ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Gastroenterologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Cancer och onkol ...
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