A neoadjuvant strategy for pancreatic adenocarcinoma increases the likelihood of receiving all components of care: lessons from a single-institution database
Authors
Piperdi, MayMcDade, Theodore P.
Shim, Joon K.
Piperdi, Bilal
Kadish, Sidney P.
Sullivan, Mary E.
Whalen, Giles F.
Tseng, Jennifer F.
UMass Chan Affiliations
Department of SurgeryDocument Type
Journal ArticlePublication Date
2010-04-02Keywords
AdenocarcinomaAdult
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
Metadata
Show full item recordAbstract
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 siteDOI
10.1111/j.1477-2574.2009.00150.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/49818PubMed ID
20590888Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1111/j.1477-2574.2009.00150.x