Neoadjuvant Chemotherapy and Radiation Improves Recurrence-free and Overall Survival in Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma.

IF 1 4区医学 Q3 SURGERY

American Surgeon Pub Date : 2024-11-01 Epub Date: 2024-04-27 DOI:10.1177/00031348241250043

Jesse K Kelley, Hordur Kolbeinsson, Sreenivasa Chandana, Benjamin Eastburg, Austin Frisch, Jessica Parker, G Paul Wright, M Mura Assifi, Mathew Chung

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引用次数: 0

Abstract

Objective: The objective of this study is to analyze the outcomes of patients with resectable/borderline resectable PDAC who receive total neoadjuvant therapy vs upfront surgery.

Methods and analysis: Patients who were treated at a single institution from 2006 to 2021 were included. The primary outcome was overall survival (OS). Secondary outcomes included disease free survival (DFS), rates of lymph node positivity, and R0 resection. All survival analyses were performed with intention-to-treat.

Results: 26 patients received neoadjuvant chemotherapy and radiation (TNT), 28 received neoadjuvant chemotherapy only (NAC), and 168 received upfront surgery. Demographics were comparable across all three groups. Patients who received TNT or NAC had longer OS and DFS compared to the surgery first patients (P < .01). Patients who received TNT had a lymph node positivity rate of 0% at time of surgery compared to 5.3% and 13.3% in the NAC and surgery-first groups, respectively (P < .01). The rate of R0 resection did not differ between groups (P = .17).

Conclusion: Patients with resectable/borderline resectable PDAC who receive neoadjuvant therapy have longer OS and RFS relative to those who receive upfront surgery.

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新辅助化疗和放疗可提高可切除和边缘可切除胰腺导管腺癌的无复发率和总生存率

研究目的本研究旨在分析可切除/边缘可切除PDAC患者接受全新药辅助治疗与前期手术治疗的疗效：方法：纳入2006年至2021年在一家机构接受治疗的患者。主要结果是总生存期（OS）。次要结果包括无病生存期（DFS）、淋巴结阳性率和R0切除率。结果：26名患者接受了新辅助化疗和放疗（TNT），28名患者仅接受了新辅助化疗（NAC），168名患者接受了前期手术。三组患者的人口统计学特征相当。与先接受手术的患者相比，接受TNT或NAC治疗的患者的OS和DFS更长（P < .01）。接受TNT治疗的患者手术时淋巴结阳性率为0%，而NAC组和先手术组的淋巴结阳性率分别为5.3%和13.3%（P < .01）。各组的R0切除率没有差异（P = .17）：结论：接受新辅助治疗的可切除/边缘可切除PDAC患者的OS和RFS均长于先期手术患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Surgeon 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

623

期刊介绍： The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.