Impact of Neoadjuvant Therapy for Pancreatic Cancer : Transatlantic Trend and Postoperative Outcomes Analysis

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Impact of Neoadjuvant Therapy for Pancreatic Cancer : Transatlantic Trend and Postoperative Outcomes Analysis

Davis, Catherine H. (author): Baylor Scott and White Hospital,Baylor Scott & White Hlth, TX USA

Augustinus, Simone (author): University of Amsterdam,Univ Amsterdam, Netherlands

de Graaf, Nine (author): University of Amsterdam,Univ Amsterdam, Netherlands

Wellner, Ulrich F. (author): University Medical Center Schleswig-Holstein,Pancreas & Clin Surg, Germany

Johansen, Karin (author): Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten

Andersson, Bodil (author): Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,Artificial Intelligence in CardioThoracic Sciences (AICTS),LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital,Lund Univ, Sweden; Lund Univ, Sweden; Skane Univ Hosp, Sweden

Beane, Joal D. (author): Ohio State University,Ohio State Univ, OH USA

Björnsson, Bergthor (author): Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US

Busch, Olivier R. (author): Baylor Scott and White Hospital,Univ Amsterdam, Netherlands

Gleeson, Elizabeth M. (author): University of North Carolina,Univ N Carolina, NC USA

van Santvoort, Hjalmar C. (author): University Medical Center Utrecht,Univ Med Ctr Utrecht, Netherlands

Tingstedt, Bobby (author): Linköpings universitet,Linköping University,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten

Williamsson, Caroline (author): Linköpings universitet,Linköping University,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten

Keck, Tobias (author): University Medical Center Schleswig-Holstein,Pancreas & Clin Surg, Germany

Besselink, Marc G. (author): Baylor Scott and White Hospital,Univ Amsterdam, Netherlands

Koerkamp, Bas Groot (author): Erasmus University Medical Center,Erasmus MC, Netherlands

Pitt, Henry A. (author): Rutgers Robert Wood Johnson Med Sch, NJ USA; 125 Little Albany St, NJ 08901 USA

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LIPPINCOTT WILLIAMS & WILKINS, 2024
2024
English 9 s.
In: Journal of the American College of Surgeons. - : LIPPINCOTT WILLIAMS & WILKINS. - 1879-1190 .- 1072-7515. ; 238:4, s. 613-621

Related links:: http://dx.doi.org/10...; show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: The introduction of modern chemotherapy a decade ago has led to increased use of neoadjuvant therapy (NAT) in patients with pancreatic ductal adenocarcinoma (PDAC). A recent North American study demonstrated increased use of NAT and improved operative outcomes in patients with PDAC. The aims of this study were to compare the use of NAT and short-term outcomes in patients with PDAC undergoing pancreatoduodenectomy (PD) among registries from the US and Canada, Germany, the Netherlands, and Sweden. STUDY DESIGN: Databases from 2 multicenter (voluntary) and 2 nationwide (mandatory) registries were queried from 2018 to 2020. Patients undergoing PD for PDAC were compared based on the use of upfront surgery vs NAT. Adoption of NAT was measured in each country over time. Thirty-day outcomes, including the composite measure (ideal outcomes), were compared by multivariable analyses. Sensitivity analyses of patients undergoing vascular resection were performed. RESULTS: Overall, 11,402 patients underwent PD for PDAC with 33.7% of patients receiving NAT. The use of NAT increased steadily from 28.3% in 2018 to 38.5% in 2020 (p < 0.0001). However, use of NAT varied widely by country: the US (46.8%), the Netherlands (44.9%), Sweden (11.0%), and Germany (7.8%). On multivariable analysis, NAT was significantly (p < 0.01) associated with reduced rates of serious morbidity, clinically relevant pancreatic fistulae, reoperations, and increased ideal outcomes. These associations remained on sensitivity analysis of patients undergoing vascular resection. CONCLUSIONS: NAT before PD for pancreatic cancer varied widely among 4 Western audits yet increased by 26% during 3 years. NAT was associated with improved short-term outcomes.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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By the university: Lund University; Linköping University

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