Survival benefit of adjuvant therapy completion with early initiation for patients with pancreatic ductal adenocarcinoma

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Kenjiro Okada, Kenichiro Uemura, Tatsuaki Sumiyoshi, Ryuta Shintakuya, Kenta Baba, Takumi Harada, Yasutaka Ishii, Shiro Oka, Yoshiaki Murakami, Shinya Takahashi
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Abstract

Aim

To evaluate the prognostic effect of initiation timing and completion of adjuvant therapy in patients with pancreatic ductal adenocarcinoma.

Methods

The medical records of patients with pancreatic ductal adenocarcinoma who underwent radical pancreatectomy between 2006 and 2022 at Hiroshima University were retrospectively reviewed. Patient characteristics, perioperative outcomes, clinicopathological factors, and survival rates were analyzed. Adjuvant indications were for all patients who had a good postoperative status as early as possible. Early initiation was defined as adjuvant initiation within 4 weeks after surgery, and completion was defined as a total of 6 months of administration.

Results

In total, 444 (294, resectable; 150, borderline resectable or locally advanced) patients who received adjuvant therapy were enrolled in this study. The median time to adjuvant therapy initiation was 20 days. In total, 328 patients with early initiation had better overall survival than those with delayed initiation, and 409 patients with adjuvant completion had better survival rates than those with incompletion. Multivariate overall survival analysis demonstrated that early adjuvant therapy initiation and completion were independent prognostic factors for prolonged survival. In total, 310 adjuvant completions with early initiation resulted in a median survival period of 81.8 months. Multivariate analysis identified severe postoperative complication as an independent risk factor preventing adjuvant completion with early initiation.

Conclusion

Adjuvant completion with early initiation may contribute to the improved survival of patients with pancreatic ductal adenocarcinoma. Preventing severe postoperative complications may facilitate adjuvant completion with early initiation.

Abstract Image

早期开始辅助治疗完成胰管腺癌患者的生存获益
目的探讨胰管腺癌辅助治疗开始时间和完成时间对患者预后的影响。方法回顾性分析广岛大学2006 ~ 2022年行根治性胰腺导管腺癌患者的病历。分析患者特征、围手术期结局、临床病理因素及生存率。所有术后状态良好的患者,尽早进行辅助指征。早期开始被定义为术后4周内辅助开始,完成被定义为总共6个月的给药。结果共444例,其中可切除294例;150例接受辅助治疗的边缘可切除或局部晚期患者参加了这项研究。辅助治疗开始的中位时间为20天。总的来说,328例早期开始治疗的患者比延迟开始治疗的患者有更好的总生存率,409例辅助完成治疗的患者比不完全完成治疗的患者有更好的生存率。多变量总生存分析表明,早期辅助治疗的开始和完成是延长生存期的独立预后因素。总共有310例早期辅助治疗完成,中位生存期为81.8个月。多因素分析表明,严重的术后并发症是阻止辅助治疗早期完成的独立危险因素。结论早期开始辅助完成治疗可提高胰管腺癌患者的生存率。预防严重的术后并发症可促进辅助手术早期完成。
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
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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