Time to the initiation of adjuvant chemotherapy does not impact survival in patients with resected pancreatic cancer

Mirkin, Katelin A.; Greenleaf, Erin K.; Hollenbeak, Christopher S.; Wong, Joyce Y.

doi:10.1002/cncr.30163

Cited by 48 publications

(40 citation statements)

References 29 publications

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“…The Japanese RCT did not include patients receiving adjuvant treatment to avoid confounding the survival benefit but it had some ethical issues because of this. The benefit of adjuvant chemotherapy after pancreatectomy in terms of pancreatic adenocarcinoma is widely known , and adjuvant treatment is recommended in the treatment guidelines for pancreatic adenocarcinoma in many countries . Our trial included 122 patients who received adjuvant treatment.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study

Jang

Kang

Han

et al. 2017

J Hepato Biliary Pancreat

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Section: Discussionmentioning

confidence: 99%

Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study

Jang

Kang

Han

et al. 2017

J Hepato Biliary Pancreat

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“…Our study also showed that the status of PALN was significantly associated with prognosis for all patients, but it was not one independent prognostic factor confirmed by multivariate survival analysis. For patients without metastasis of PALN, preoperative CA19-9 level, unintentional weight loss, back pain, adjuvant chemotherapy, tumor size, T status, N status, margin involvement, portal or superior mesenteric vein invasion, and lymph node retrieved were associated with survival in our study, and back pain, tumor size, T status, N status, and portal or superior mesenteric vein invasion were [25] suggested that time to the initiation of adjuvant In conclusion, pancreatic head cancer with metastasis of PALN had poor prognosis compared with that without metastasis of PALN, but status of PALN was not the independent prognostic factor. Patients with or without metastasis of PALN had different prognostic factors, several factors had impact on survival for patients without metastasis of PALN, whereas adjuvant therapy was the only prognostic factor for patients with metastasis of PALN.…”

Section: Discussionmentioning

confidence: 49%

“…For instance, a new study designed by Mirkin et al. suggested that time to the initiation of adjuvant chemotherapy does not impact survival in patients with resected pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Analysis of prognostic factors for pancreatic head cancer according to para‐aortic lymph node

et al. 2016

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This study was designed to investigate the relationship between prognosis of pancreatic head cancer and status of para‐aortic lymph node (PALN). A total of 233 patients with pancreatic head cancer who underwent surgical resection between February 2008 and October 2015 were enrolled in this study. Univariate and multivariate analyses were used to reveal the prognostic factors. Prognostic factors for patients with and without metastasis of PALN were analyzed, respectively. The 5‐year overall survival (OS) rate was 19.0% for all patients, and the positive rate of PALN metastasis was 18.9% (44/233). The 1‐, 2‐, 3‐, and 5‐year OS rates in patients without metastasis of PALN were 79.4%, 54.8%, 36.4%, and 22.9%, respectively, whereas the 1‐, 2‐, and 3‐year survival rates were 54.0%, 14.8%, and 0%, respectively, in patients with metastasis of PALN. Preoperative CA19‐9 level, tumor size, T status, N status, and adjuvant therapy were independent prognostic factors for all patients confirmed by multivariate analysis. For patients without PALN metastasis, back pain, tumor size, T status, N status, portal or superior mesenteric vein invasion, and adjuvant therapy were independent prognostic factors, while the only one influence factor for 2‐year OS was adjuvant therapy for patients with metastasis of PALN. Metastasis of PALN was associated with poor prognosis for patients with pancreatic head cancer. Patients with and without metastasis of PALN had different prognostic factors, and adjuvant therapy was the only prognostic factor for patients with metastasis of PALN.

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“…However, a retrospective analysis of the NCDB found that MIS did not improve use or initiation of adjuvant chemotherapy for patients with PDAC [48]. Moreover, the survival impact of the initiation time of adjuvant chemotherapy in patients with resected PDAC remains uncertain since studies showed con icting results [49,50]. In our opinion, neither procedure is technically superior, but e ciency would largely depend on the techniques of the surgeon.…”

Section: Discussionmentioning

confidence: 89%

Total laparoscopic versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matching analysis with meta-analysis

Chen¹,

Pan²,

Mou³

et al. 2020

Preprint

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Background Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer mortality worldwide. Total laparoscopic pancreaticoduodenectomy (TLPD) have been used in the treatment of benign and low-grade diseases on the pancreatic head. It is necessary to expand the current knowledge on the feasibility and safety of TLPD for PDAC treatment. We aimed to assess the surgical and oncological outcomes of TLPD for patients with PDAC by comparing them with open pancreaticoduodenectomy (OPD). Methods Data regarding patients who underwent pancreaticoduodenectomy for PDAC treatment from January 2013 to January 2019 in our hospital were obtained. Baseline characteristics, intraoperative effects, postoperative recoveries, and survival outcomes were compared. To overcome selection bias, we performed a 1:1 match using propensity score matching (PSM) between TLPD and OPD. We also conducted a systematic review and meta-analysis. Results The original cohort included 276 patients (TLPD; 98 patients, OPD; 178 patients). After PSM, there were 89 patients in each group and the patient demographics were well matched. Of the 98 patients who underwent TLPD, 8 (8.2%) required conversions to laparotomies. Compared to OPD, TLPD could be performed with longer operative times, had less blood loss, and had lower overall morbidities. Regarding oncological and survival outcomes, there were no significant differences in tumor size, R0 resection rates and tumor stages between groups. However, TLPD had an advantage over OPD in terms of retrieved lymph nodes (21.9 ± 6.6 vs. 18.9 ± 5.4, p < 0.01). There were no statistically signiﬁcant differences between the groups in recurrence patterns, and the 3-year recurrence-free and overall survival rates were comparable between the two groups. Meta-analysis further confirmed that the TLPD were associated with longer operative times, less blood loss, shorter hospitalizations, lower morbidities, and a greater number of retrieved lymph nodes. Conclusions TLPD are feasible and oncologically safe procedures for PDAC treatments. Postoperative outcomes and long-term survival after TLPD are superior, or not inferior, to OPD, and could be a promising alternative to open surgery for PDAC treatments. Our findings should be further evaluated by multicenter or randomized controlled trials.

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Time to the initiation of adjuvant chemotherapy does not impact survival in patients with resected pancreatic cancer

Cited by 48 publications

References 29 publications

Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study

Long‐term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study

Analysis of prognostic factors for pancreatic head cancer according to para‐aortic lymph node

Total laparoscopic versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matching analysis with meta-analysis

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