Takeaway
- Neoadjuvant therapy (NAT) dramatically increases the rate of tumor-free resection (R0) and decreases local recurrence in patients with pancreatic ductal adenocarcinoma (PDAC).
- Adjuvant chemotherapy (AC) can improve survival for patients after microscopic tumor-positive resection (R1).
Why this matters
- NAT can make it easier for surgeons to achieve complete resection, especially in patients with borderline resectable or locally advanced PDAC.
Study design
- Researchers reviewed the health records of consecutive patients undergoing curative resection for PDAC (n=427; median age, 66 [range, 34-84] years; men, 59.5%), using propensity score analysis to assess the clinical effect of NAT and AC on R status, OS, and DFS.
- Funding: None.
Key results
- The R0 rate for NAT+ patients (97.2%) was considerably higher than for NAT− patients (69.6%; both P<.0001 as was local recurrence vs p=".0013).">
- Median survival time for AC+ patients was not significantly different after R0 or R1 (43.0 vs 33.3 months; matching HR, 1.212; P=.5708), nor was DFS (20.6 vs 17.7 months; matching HR, 1.020; P=.9482).
Limitations
- The study was retrospective and single center.
- NAT and AC regimens were not the same for all patients.
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