Pancreatic cancer: neoadjuvant therapy increases clean resections

  • Yamada S & al.
  • Surg Today
  • 24 Oct 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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.