AI Article Synopsis
- - The study investigates the impact of extended pre-operative therapy duration on survival rates for patients with borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC), as opposed to the typical 2-4 months of treatment.
- - After reviewing data from 1992-2014, results showed that patients who received at least 6 months of pre-operative treatment had significantly better overall survival compared to those who received less (52.8 months vs. 32.1 months).
- - The study concludes that monitoring the decline of CA19-9 levels can help determine treatment duration, advocating for 6 months of therapy, except for patients whose levels normalize, who may undergo
Article Abstract
Background: Compared to the widely adopted 2-4 months of pre-operative therapy for patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC), our institution tends to administer a longer duration before considering surgical resection. Using this unique approach, the aim of this study was to determine pre-operative variables associated with survival.
Methods: Records from patients with BR/LA PDAC who underwent attempt at surgical resection from 1992-2014 were reviewed.
Results: After a median duration of 6 months of pre-operative treatment, 109 patients with BR/LA PDAC (BR 63, LA 46) were explored; 93 (85.3 %) underwent pancreatectomy. Those who received at least 6 months of pre-operative treatment had longer median overall survival (OS) than those who received less (52.8 vs. 32.1 months, P = 0.044). On multivariate analysis, pre-operative treatment duration was the strongest predictor of survival (hazard ratio (HR) 4.79, P = 0.043). However, OS was similar in those whose CA19-9 normalized regardless of whether they received more or less than 6 months of chemotherapy (71.4 vs. 101.8 months, P = 0.930).
Conclusions: Pre-operative CA19-9 decline can guide treatment duration in patients with BR/LA PDAC. We endorse 6 months of therapy except in those patients whose values normalize, where surgery can be considered after a shorter course.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919020 | PMC |
| http://dx.doi.org/10.1007/s11605-016-3149-4 | DOI Listing |
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