Hospital admission during neoadjuvant therapy for pancreatic ductal adenocarcinoma: prevalence, predictors, and prognosis.

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-08-29 DOI:10.1016/j.hpb.2025.08.015

Patrick W Underwood, Thomas Leuschner, Amanda K Walsh, Eric D Miller, Kenneth L Pitter, Anne M Noonan, Ashish Manne, Shafia Rahman, Pannaga Malalur, Arjun Mittra, Mary E Dillhoff, Susan Tsai, Timothy M Pawlik, Jordan M Cloyd

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引用次数: 0

Abstract

Background: Neoadjuvant therapy (NT) is increasingly utilized for localized pancreatic ductal adenocarcinoma (PDAC). The incidence of hospital admission during NT and its impact on clinical outcomes is poorly understood.

Methods: Patients with localized PDAC who received intent-to-treat NT between 2018 and 2023 at a single institution were retrospectively reviewed. Hospital admission rates, reasons, and the impact on overall survival (OS) were assessed.

Results: Among 305 patients, 58.4 % were male, 90.7 % were white, and median age was 66. Patients had potentially resectable (31.1 %), borderline resectable (36.7 %), and locally advanced disease (32.1 %). The median duration of NT was 119 days. Overall, 80 (26.2 %) patients required hospital admission during NT (range 1-5). The most common reasons for admission were fever/infection (33.8 %) and gastrointestinal symptoms (20.8 %). Factors associated with hospital admission included LA anatomic stage (OR 2.56; 95%CI: 1.22-5.39; p = 0.013) and BMI (OR 1.09; 95%CI: 1.04-1.15; p < 0.001). Hospital admission was associated with reduced odds of undergoing surgical resection (OR 0.27; 95%CI: 0.14-0.54; p < 0.001) and worse OS (median 14.6 months; 95%CI: 11.3-18.0 vs 22.6 months; 95%CI: 17.2-28.1; p < 0.001).

Conclusion: Hospital admission is common among patients with PDAC receiving NT and associated with worse outcomes. Further research on optimizing care delivery during NT is critical to improve outcomes.

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胰腺导管腺癌新辅助治疗期间住院：患病率、预测因素和预后。

背景：新辅助治疗（NT）越来越多地用于局限性胰腺导管腺癌（PDAC）。NT期间住院的发生率及其对临床结果的影响尚不清楚。方法：回顾性分析2018年至2023年间在单一机构接受NT治疗的局限性PDAC患者。评估住院率、原因和对总生存期（OS）的影响。结果：305例患者中，男性58.4%，白人90.7%，中位年龄66岁。患者有潜在可切除（31.1%）、边缘性可切除（36.7%）和局部晚期（32.1%）。NT的中位持续时间为119天。总体而言，80例（26.2%）患者在NT期间需要住院（范围1-5）。最常见的入院原因是发热/感染（33.8%）和胃肠道症状（20.8%）。与住院相关的因素包括LA解剖分期（OR 2.56; 95%CI: 1.22-5.39; p = 0.013）和BMI （OR 1.09; 95%CI: 1.04-1.15; p < 0.001）。住院与手术切除的几率降低（OR 0.27; 95%CI: 0.14-0.54; p < 0.001）和更差的OS（中位14.6个月；95%CI: 11.3-18.0 vs 22.6个月；95%CI: 17.2-28.1; p < 0.001）相关。结论：住院在接受NT治疗的PDAC患者中很常见，且与较差的预后相关。进一步研究优化NT期间的护理服务对改善结果至关重要。

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

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).