Neoadjuvant Therapy is Associated with Improved Survival in Borderline-Resectable Pancreatic Cancer

Background Neoadjuvant therapy has shown value in various cancer types. The role of neoadjuvant therapy in pancreatic ductal adenocarcinoma (PDAC), however, remains unknown. The aim of the present work is to evaluate the effect of neoadjuvant therapy on the survival of patients with borderline-resec...

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Bibliographic Details
Published in:Annals of surgical oncology 2020-04, Vol.27 (4), p.1191-1200
Main Authors: Chawla, Akhil, Molina, George, Pak, Linda M., Rosenthal, Michael, Mancias, Joseph D., Clancy, Thomas E., Wolpin, Brian M., Wang, Jiping
Format: Article
Language:English
Subjects:
Adenocarcinoma
Aged
Biopsy
Carcinoma, Pancreatic Ductal - pathology
Carcinoma, Pancreatic Ductal - therapy
Combined Modality Therapy
Databases, Factual
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy - mortality
Oncology
Pancreatectomy - mortality
Pancreatic cancer
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Pancreatic Tumors
Retrospective Studies
Surgery
Surgical Oncology
Survival
Survival Analysis
Treatment Outcome
United States - epidemiology
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Summary:Background Neoadjuvant therapy has shown value in various cancer types. The role of neoadjuvant therapy in pancreatic ductal adenocarcinoma (PDAC), however, remains unknown. The aim of the present work is to evaluate the effect of neoadjuvant therapy on the survival of patients with borderline-resectable PDAC. Patients and Methods Between 2004 and 2015, 7730 patients with resectable PDAC and 1980 patients with borderline-resectable PDAC were identified from the National Cancer Database (NCDB). Survival was compared between resectable and borderline-resectable patients. Survival and pathologic characteristics were also compared within borderline-resectable patients who received neoadjuvant therapy and those who received adjuvant therapy alone. Kaplan–Meier method and Cox proportional-hazard models were used for analysis. Results Median overall survival (mOS) of all patients with resectable PDAC was similar to that of patients with borderline-resectable disease treated with neoadjuvant therapy (26.5 versus 25.7 months, p  = 0.78). Patients with borderline-resectable disease treated with neoadjuvant therapy had improved mOS compared with borderline-resectable patients treated with adjuvant therapy alone (25.7 versus 19.6 months, p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-019-08087-z