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  • Davis, Catherine H.Baylor Scott and White Hospital (author)

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

  • Article/chapterEnglish2024

Publisher, publication year, extent ...

  • 2024
  • 9 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:b9de9bcd-e639-45a9-a5b1-19798046c884
  • https://lup.lub.lu.se/record/b9de9bcd-e639-45a9-a5b1-19798046c884URI
  • https://doi.org/10.1097/XCS.0000000000000971DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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.

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  • Augustinus, SimoneUniversity of Amsterdam (author)
  • de Graaf, NineUniversity of Amsterdam (author)
  • Wellner, Ulrich F.University Medical Center Schleswig-Holstein (author)
  • Johansen, KarinLinköping University (author)
  • Andersson, BodilLund 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(Swepub:lu)kir-ban (author)
  • Beane, Joal D.Ohio State University (author)
  • Björnsson, BergthorLinköping University (author)
  • Busch, Olivier R.Baylor Scott and White Hospital (author)
  • Gleeson, Elizabeth M.University of North Carolina (author)
  • van Santvoort, Hjalmar C.University Medical Center Utrecht (author)
  • Tingstedt, BobbyLinköping University (author)
  • Williamsson, CarolineLinköping University (author)
  • Keck, TobiasUniversity Medical Center Schleswig-Holstein (author)
  • Besselink, Marc G.Baylor Scott and White Hospital (author)
  • Koerkamp, Bas GrootErasmus University Medical Center (author)
  • Pitt, Henry A. (author)
  • Baylor Scott and White HospitalUniversity of Amsterdam (creator_code:org_t)
  • Global Audits on Pancreatic Surgery Group (GAPASURG)

Related titles

  • In:Journal of the American College of Surgeons238:4, s. 613-6211879-1190

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