AI Article Synopsis
- Adjuvant chemotherapy or chemoradiation is recommended for patients with resected pancreatic adenocarcinoma to potentially improve survival outcomes.
- A study of 28,440 patients revealed that adjuvant therapies, especially chemoradiation, significantly enhanced median and 5-year survival rates compared to no treatment, particularly in R1 resection cases.
- Overall, while both adjuvant therapies provide benefits, chemoradiation showed the most substantial survival improvement, especially among patients with node-positive cancers.
Article Abstract
Background: Adjuvant chemotherapy or chemoradiation is often recommended for resected pancreatic adenocarcinoma. We sought to examine the impact of these therapies on R1 resected pancreatic cancer.
Methods: Utilizing the National Cancer Database we identified patients who underwent pancreatic resection for adenocarcinoma. Patients were stratified by resection status and adjuvant therapy.
Results: We identified 28,440 patients who underwent pancreatic resection. Patients with tumor size >2 cm were more likely to undergo R1 resections, p < 0.001. Adjuvant therapy improved survival in all patients with median and 5-year survival: adjuvant chemotherapy (21.7 months, 17.45%), chemoradiation (23.3 months, 20.9%) vs no adjuvant therapy (19.5 months, 19.1%), p < 0.001. In the R1 resection cohort survival was also improved with adjuvant therapy with chemoradiation demonstrating the most significant improvement: adjuvant chemotherapy (15.9 months, 6.5%), chemoradiation (18.7 months, 11.2%) vs no adjuvant therapy (12.5 months, 8.7%), p < 0.001. Chemoradiation but not adjuvant chemotherapy improved survival in the R1 node negative, p < 0.004, and node positive, p < 0.001. Adjuvant chemotherapy benefited survival in R1 node positive patients, p < 0.001.
Conclusions: Patients with pancreatic cancer who undergo R1 resection have significant improvement in survival when treated with adjuvant chemoradiation and adjuvant chemotherapy. However, benefits were greater in those receiving adjuvant chemoradiation.
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| http://dx.doi.org/10.1016/j.pan.2022.03.008 | DOI Listing |
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