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    A neoadjuvant strategy for pancreatic adenocarcinoma increases the likelihood of receiving all components of care: lessons from a single-institution database

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    Authors
    Piperdi, May
    McDade, Theodore P.
    Shim, Joon K.
    Piperdi, Bilal
    Kadish, Sidney P.
    Sullivan, Mary E.
    Whalen, Giles F.
    Tseng, Jennifer F.
    UMass Chan Affiliations
    Department of Surgery
    Document Type
    Journal Article
    Publication Date
    2010-04-02
    Keywords
    Adenocarcinoma
    Adult
    Aged
    Aged, 80 and over
    Antibodies, Monoclonal
    Antineoplastic Agents
    Chemotherapy, Adjuvant
    Cohort Studies
    Deoxycytidine
    Female
    Fluorouracil
    Humans
    Male
    Middle Aged
    *Neoadjuvant Therapy
    Pancreatectomy
    Pancreatic Neoplasms
    Pancreaticoduodenectomy
    Postoperative Complications
    Radiotherapy, Adjuvant
    Surgery
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    Link to Full Text
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889273/pdf/hpb0012-0204.pdf
    Abstract
    BACKGROUND: Recent studies have shown adjuvant therapy improves outcomes from pancreatic cancer (PC). This study investigates receipt and timing of PC treatments, and association with outcomes. METHODS: The analysis cohort consisted of patients with newly-diagnosed PC at a single institution over 5 years. Primary Endpoints were (i) receipt of recommended therapy, and (ii) overall survival (OS). RESULTS: Among 102 patients, 52 underwent resection. Out of 36 localized resected and 16 locally advanced resected (LAR) patients, 26 and 13, respectively, received adjuvant therapy. Six of the latter group received neoadjuvant therapy. Median OS for resected patients was 15.7 months (range 0.6-51.4), compared with 7.7 for unresected patients (range 0.4-32.0) (P < 0.001), and 14.0 months for patients with resection alone (range 0.6-24.4) vs. 16.1 for patients who also received adjuvant therapy (range 3.2-51.4) (P= 0.027). Out of 46 patients undergoing up-front resection, 33 had R0 surgical margins. For the six LAR patients undergoing neoadjuvant therapy, all margins were R0. CONCLUSION: After resection, a substantial proportion of patients do not receive adjuvant therapy, and have worse survival. In this study, neoadjuvant treatment increased both the proportion of patients receiving all components of recommended therapy and the R0 resection rate.
    Source
    HPB (Oxford). 2010 Apr;12(3):204-10. Link to article on publisher's site
    DOI
    10.1111/j.1477-2574.2009.00150.x
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49818
    PubMed ID
    20590888
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1477-2574.2009.00150.x
    Scopus Count
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    UMass Chan Faculty and Researcher Publications

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