Neoadjuvant Chemotherapy for Pancreatic Adenocarcinoma Lessens the Deleterious Effect of Omission of Adjuvant Chemotherapy

Background Despite controversy regarding the role of neoadjuvant chemotherapy (NAC) in pancreatic adenocarcinoma, nearly half of resected patients do not receive chemotherapy postoperatively. This study aimed to examine whether use of NAC compensates for omission of adjuvant chemotherapy (AC) for re...

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Bibliographic Details
Published in:Annals of surgical oncology 2021-07, Vol.28 (7), p.3800-3807
Main Authors: Adam, Mohamed Abdelgadir, Nassour, Ibrahim, Hoehn, Richard, Hlavin, Callie A., Bahary, Nathan, Bartlett, David L., Lee, Kenneth K. W., Zureikat, Amer H., Paniccia, Alessandro
Format: Article
Language:English
Subjects:
Adenocarcinoma
Chemotherapy
Medicine
Medicine & Public Health
Oncology
Pancreas
Pancreatic cancer
Pancreatic Tumors
Surgery
Surgical Oncology
Survival
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Summary:Background Despite controversy regarding the role of neoadjuvant chemotherapy (NAC) in pancreatic adenocarcinoma, nearly half of resected patients do not receive chemotherapy postoperatively. This study aimed to examine whether use of NAC compensates for omission of adjuvant chemotherapy (AC) for resected pancreatic adenocarcinoma. Methods Adults with resected stages 1 to 3 pancreatic adenocarcinoma were enrolled from the National Cancer Database NCDB (2006–2016). Overall survival (OS) analyses were used to examine the impact of NAC on those who did not receive AC. Results The study analyzed a national cohort of 56,286 patients: 30% without chemotherapy, 11% with NAC, 54% with AC, and 5% with NAC plus AC. Use of NAC increased by more than 400% from 2006 to 2016, whereas the rates for omission of chemotherapy remained unchanged. The OS rates were similar between the patients who received NAC and those who received AC (hazard ratio, 0.97; p  = 0.21). Among the patients who did not receive AC, NAC was associated with improved OS (26.7 vs. 18.4 months; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-020-09446-x