Impact of Neoadjuvant Therapy on Oncological Outcomes of Patients With Distal Pancreatic Adenocarcinoma.

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2024-09-30 DOI:10.1002/jso.27856

Asmita Chopra, Anthony Gebran, Hussein Khachfe, Rudy El Asmar, Ibrahim Nassour, Sowmya Narayanan, Samer AlMasri, Aatur Singhi, Kenneth Lee, Amer Zureikat, Alessandro Paniccia

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引用次数: 0

Abstract

Background: Distal pancreatic ductal adenocarcinoma (D-PDAC) often presents at an advanced stage. The efficacy of neoadjuvant therapy (NAT) in improving outcomes for D-PDAC is not well-established. This study evaluates the impact of NAT on the oncological outcomes of patients with D-PDAC.

Methods: A retrospective cohort study of consecutive patients with resectable and borderline-resectable D-PDAC treated at a single center from 2012 to 2020 was performed. Stratification was based on initial treatment-NAT or surgery first (SF). Survival analysis, following intention-to-treat framework, used Kaplan-Meier and Cox regression to assess NAT's impact on progression-free survival (PFS) and overall survival (OS) of D-PDAC.

Results: Among 141 patients (median age 69.8 years, 51.8% females) included in the study, 71 (50.4%) received NAT and 70 (49.6%) were planned for SF. Patients receiving NAT were younger (65.9 vs. 72.6 years) and had higher incidence of borderline-resectable disease (31% vs. 4.3%) (both p < 0.05) than those undergoing SF. Thirteen patients (18.3%) undergoing NAT and five (7.1%) in SF group, failed to undergo resection. Univariate comparison showed no difference in the PFS (SF:13.97 vs. NAT:17.00 months, p = 0.6), and OS (SF:23.73 vs. NAT:32.53 months, p = 0.35). Multivariate Cox regression analysis noted significantly improved PFS (HR = 0.64, 95%CI = 0.42-0.96, p = 0.031) and OS (HR = 0.60, 95%CI = 0.39-0.93, p = 0.021) with NAT.

Conclusion: NAT is associated with improved PFS and OS in patients with -D-PDAC. Further randomized controlled trials are warranted to confirm these findings.

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新辅助疗法对远端胰腺腺癌患者肿瘤治疗效果的影响

背景：远端胰腺导管腺癌（D-PDAC）通常处于晚期。新辅助治疗（NAT）在改善D-PDAC预后方面的疗效尚未得到充分证实。本研究评估了 NAT 对 D-PDAC 患者肿瘤治疗效果的影响：一项回顾性队列研究针对2012年至2020年期间在一个中心接受治疗的可切除和边缘可切除D-PDAC连续患者。根据初始治疗--NAT或先手术（SF）进行分层。根据意向治疗框架，采用卡普兰-梅耶尔和考克斯回归进行生存分析，评估NAT对D-PDAC无进展生存期（PFS）和总生存期（OS）的影响：在纳入研究的141名患者（中位年龄69.8岁，51.8%为女性）中，71人（50.4%）接受了NAT治疗，70人（49.6%）计划接受SF治疗。接受 NAT 治疗的患者更年轻（65.9 岁对 72.6 岁），边缘可切除疾病的发生率更高（31% 对 4.3%）（均为 p 结论：NAT 与改善 PFS 相关：NAT可改善-D-PDAC患者的PFS和OS。需要进一步的随机对照试验来证实这些发现。

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

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.