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Long-Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma

  • 0Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Cancer Medicine +

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November 18, 2024

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November 18, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Neoadjuvant therapy significantly improves survival and surgical outcomes for pancreatic ductal adenocarcinoma (PDAC) compared to upfront surgery. This approach offers better progression-free survival and enhanced resection rates for PDAC patients.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis.
  • Treatment strategies for resectable PDAC include upfront surgery and neoadjuvant therapy followed by surgery.
  • Comparing long-term outcomes of these approaches is crucial for optimizing patient care.

Purpose Of The Study

  • To compare the overall survival (OS) and progression-free survival (PFS) between neoadjuvant therapy and upfront surgery in resectable PDAC.
  • To evaluate the impact of neoadjuvant therapy on surgical outcomes, including R0 resection rates, tumor size, and lymphovascular invasion.

Main Methods

  • Retrospective analysis of 202 patients with resectable PDAC.
  • Comparison between 167 patients who underwent upfront surgery and 35 patients who received neoadjuvant therapy.
  • Propensity score matching was employed to minimize selection bias and ensure comparable groups.

Main Results

  • Neoadjuvant therapy demonstrated significantly longer OS (72.7 vs. 28.3 months) and PFS (29.6 vs. 13.2 months) compared to upfront surgery.
  • Neoadjuvant therapy resulted in higher R0 resection rates (74.3% vs. 49.5%), smaller tumor size (22.0 vs. 28.0 mm), and reduced lymphovascular invasion (20.0% vs. 52.4%).

Conclusions

  • Neoadjuvant therapy offers significant survival benefits and improved surgical outcomes for patients with resectable PDAC.
  • These findings suggest neoadjuvant therapy is a valuable strategy for managing PDAC, potentially delaying disease progression and enhancing resectability.
  • Further prospective studies are warranted to confirm these results and establish neoadjuvant therapy as a standard of care for resectable PDAC.

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