Long-Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-17 DOI:10.1002/cam4.70363

Kyung In Shin, Min Sung Yoon, Jee Hoon Kim, Won Joon Jang, Galam Leem, Jung Hyun Jo, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Ho Kyoung Hwang, Chang Moo Kang, Seung-seob Kim, Mi-Suk Park, Hee Seung Lee, Seungmin Bang

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Abstract

Introduction

This study aimed to compare the long-term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression-free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC).

Methods

We retrospectively analyzed 202 patients, including 167 who had upfront surgery and 35 who received neoadjuvant therapy followed by surgery. Surgical outcomes and survival rates were compared using propensity score matching to minimize selection bias.

Results

Neoadjuvant therapy showed significantly longer 75% OS (72.7 months vs. 28.3 months, p = 0.032) and PFS (29.6 months vs. 13.2 months, p < 0.001) compared to upfront surgery. Additionally, neoadjuvant therapy demonstrated significant improvements in surgical outcomes, including higher R0 resection rates (74.3% vs. 49.5%, p = 0.034), reduced tumor size (22.0 mm vs. 28.0 mm, p = 0.001), and decreased lymphovascular invasion (20.0% vs. 52.4%, p = 0.001).

Conclusion

Our study demonstrates the potential benefits of neoadjuvant therapy for resectable PDAC. The improved survival rates, delayed disease progression, and enhanced surgical outcomes underscore the potential of neoadjuvant therapy in addressing this aggressive disease. Despite limitations such as the retrospective design and small sample size, these findings support the effectiveness of neoadjuvant therapy in improving treatment outcomes for PDAC patients in real-world settings. Further prospective studies are required to validate these results.

Abstract Image

查看原文本刊更多论文

可切除胰腺导管腺癌的新辅助治疗与前期手术治疗的长期疗效。

简介本研究旨在比较新辅助治疗和前期手术对可切除胰腺导管腺癌（PDAC）患者总生存期（OS）和无进展生存期（PFS）的长期影响：我们对202名患者进行了回顾性分析，其中167名患者接受了前期手术，35名患者接受了新辅助治疗，随后接受了手术。我们采用倾向评分匹配法对手术结果和生存率进行了比较，以尽量减少选择偏倚：结果：新辅助治疗显著延长了 75% 的 OS（72.7 个月 vs. 28.3 个月，p = 0.032）和 PFS（29.6 个月 vs. 13.2 个月，p 结论：我们的研究证明了新辅助治疗对可切除PDAC的潜在益处。生存率的提高、疾病进展的延缓以及手术效果的改善，都凸显了新辅助治疗在治疗这种侵袭性疾病方面的潜力。尽管存在回顾性设计和样本量较小等局限性，但这些研究结果支持新辅助疗法在实际环境中改善PDAC患者治疗效果的有效性。要验证这些结果，还需要进一步的前瞻性研究。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.