- Commencement of adjuvant therapy 28-59 days after resection was associated with the best survival outcomes in patients with stage I/II pancreatic cancer.
- Initiation after 59 days was linked to better survival than no adjuvant therapy.
Why this matters
- Previous studies showed no survival difference with delay, but may have missed the optimal window.
- Retrospective analysis of 7548 patients from the National Cancer Database.
- Funding: None disclosed.
- 5453 patients (72.2%) received adjuvant therapy, 42.7% in the 40-60-day range.
- 269 started early (
- 3048 were in the reference group (28-59 days).
- 2136 started late (>59 days).
- Median follow-up was 38.6 months.
- The lowest mortality was associated with the reference group (days 28-59):
- Early vs reference mortality: HR, 1.17; P=.03.
- Late vs reference mortality: HR, 1.09; P=.008.
- In propensity-matched pairs, the reference group had better 2-year OS:
- vs early (268 pairs): 52.5% vs 45.1% (P=.02), and
- vs late (2042 pairs): 51.3% vs 45.4% (P=.01).
- The late group had better OS vs surgery alone in a multivariate analysis (HR, 0.75; P<.001 and in an analysis of matched pairs os vs p>
- Retrospective analysis.