TY - JOUR
T1 - An evaluation of adjuvant chemotherapy following neoadjuvant chemotherapy and resection for borderline resectable and locally advanced pancreatic cancer
AU - Zhang, Chunmeng
AU - Wu, Ruiqian
AU - Smith, Lynette M.
AU - Baine, Michael
AU - Lin, Chi
AU - Reames, Bradley N.
N1 - Funding Information:
This study utilized the National Cancer Database (NCDB), which is a clinical oncology database jointly sponsored by the American College of Surgeons and the American Cancer Society. The NCDB includes patients from over 1500 Commission on Cancer-accredited facilities and more than 34 million historical records, and encompasses 70% of newly diagnosed cancer cases nationwide. 13 The institutional review board of the University of Nebraska Medical Center approved this study and waived the requirement for informed consent.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/7
Y1 - 2022/7
N2 - Background: In borderline resectable and locally advanced (BRLA) pancreatic cancer patients, the role of adjuvant therapy (AT) after neoadjuvant therapy (NAT) and curative-intent resection is poorly understood. Methods: Using the National Cancer Database (NCDB) between 2011 and 2017, we identified BRLA patients who received NAT and resection. Kaplan-Meier analysis and multivariable Cox proportional hazards (PH) regression were performed to examine the association between AT and overall survival (OS). Results: Of 17,905 BRLA patients identified, 764 received NAT and resection, of which 203 received AT. Median age was 63 years, and 53.1% were female. Kaplan Meier analysis revealed no differences in median OS between AT vs non-AT groups (28.9 vs 30.1months, p = 0.498). In the multivariable Cox PH model, after adjusting for other factors, when margin was positive, AT was associated with an improved survival (HR 0.54, 95%CI 0.32–0.90, p = 0.031). Conclusion: AT was not associated with survival in BRLA patients who received NAT and resection except in patients with positive margins. Further research is necessary to better understand the role of AT following NAT in patients with BRLA.
AB - Background: In borderline resectable and locally advanced (BRLA) pancreatic cancer patients, the role of adjuvant therapy (AT) after neoadjuvant therapy (NAT) and curative-intent resection is poorly understood. Methods: Using the National Cancer Database (NCDB) between 2011 and 2017, we identified BRLA patients who received NAT and resection. Kaplan-Meier analysis and multivariable Cox proportional hazards (PH) regression were performed to examine the association between AT and overall survival (OS). Results: Of 17,905 BRLA patients identified, 764 received NAT and resection, of which 203 received AT. Median age was 63 years, and 53.1% were female. Kaplan Meier analysis revealed no differences in median OS between AT vs non-AT groups (28.9 vs 30.1months, p = 0.498). In the multivariable Cox PH model, after adjusting for other factors, when margin was positive, AT was associated with an improved survival (HR 0.54, 95%CI 0.32–0.90, p = 0.031). Conclusion: AT was not associated with survival in BRLA patients who received NAT and resection except in patients with positive margins. Further research is necessary to better understand the role of AT following NAT in patients with BRLA.
KW - Adjuvant chemotherapy
KW - Borderline resectable
KW - Locally advanced
KW - Pancreatic cancer
KW - Pancreatic surgery
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U2 - 10.1016/j.amjsurg.2021.12.018
DO - 10.1016/j.amjsurg.2021.12.018
M3 - Article
C2 - 34973686
AN - SCOPUS:85122127709
SN - 0002-9610
VL - 224
SP - 51
EP - 57
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 1
ER -