Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma
ABSTRACT Introduction This study aimed to compare the long‐term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression‐free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods We retrospectively analyzed 202 patients, inclu...
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| Format: | Article |
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Wiley
2024-11-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70363 |
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| author | Kyung In Shin Min Sung Yoon Jee Hoon Kim Won Joon Jang Galam Leem Jung Hyun Jo Moon Jae Chung Jeong Youp Park Seung Woo Park Ho Kyoung Hwang Chang Moo Kang Seung‐seob Kim Mi‐Suk Park Hee Seung Lee Seungmin Bang |
| author_facet | Kyung In Shin Min Sung Yoon Jee Hoon Kim Won Joon Jang Galam Leem Jung Hyun Jo Moon Jae Chung Jeong Youp Park Seung Woo Park Ho Kyoung Hwang Chang Moo Kang Seung‐seob Kim Mi‐Suk Park Hee Seung Lee Seungmin Bang |
| author_sort | Kyung In Shin |
| collection | DOAJ |
| description | ABSTRACT Introduction This study aimed to compare the long‐term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression‐free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods We retrospectively analyzed 202 patients, including 167 who had upfront surgery and 35 who received neoadjuvant therapy followed by surgery. Surgical outcomes and survival rates were compared using propensity score matching to minimize selection bias. Results Neoadjuvant therapy showed significantly longer 75% OS (72.7 months vs. 28.3 months, p = 0.032) and PFS (29.6 months vs. 13.2 months, p < 0.001) compared to upfront surgery. Additionally, neoadjuvant therapy demonstrated significant improvements in surgical outcomes, including higher R0 resection rates (74.3% vs. 49.5%, p = 0.034), reduced tumor size (22.0 mm vs. 28.0 mm, p = 0.001), and decreased lymphovascular invasion (20.0% vs. 52.4%, p = 0.001). Conclusion Our study demonstrates the potential benefits of neoadjuvant therapy for resectable PDAC. The improved survival rates, delayed disease progression, and enhanced surgical outcomes underscore the potential of neoadjuvant therapy in addressing this aggressive disease. Despite limitations such as the retrospective design and small sample size, these findings support the effectiveness of neoadjuvant therapy in improving treatment outcomes for PDAC patients in real‐world settings. Further prospective studies are required to validate these results. |
| format | Article |
| id | doaj-art-1ca9d9b033dc43c39cf6e7ac0dfb99f3 |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-1ca9d9b033dc43c39cf6e7ac0dfb99f32025-08-20T02:49:05ZengWileyCancer Medicine2045-76342024-11-011322n/an/a10.1002/cam4.70363Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal AdenocarcinomaKyung In Shin0Min Sung Yoon1Jee Hoon Kim2Won Joon Jang3Galam Leem4Jung Hyun Jo5Moon Jae Chung6Jeong Youp Park7Seung Woo Park8Ho Kyoung Hwang9Chang Moo Kang10Seung‐seob Kim11Mi‐Suk Park12Hee Seung Lee13Seungmin Bang14Division of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDepartment of Hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Seoul KoreaDepartment of Hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Seoul KoreaDepartment of Hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Seoul KoreaDepartment of Radiology, Research Institute of Radiological Science Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaDivision of Gastroenterology, Department of Internal Medicine Yonsei University College of Medicine Seoul KoreaABSTRACT Introduction This study aimed to compare the long‐term effects of neoadjuvant therapy and upfront surgery on overall survival (OS) and progression‐free survival (PFS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods We retrospectively analyzed 202 patients, including 167 who had upfront surgery and 35 who received neoadjuvant therapy followed by surgery. Surgical outcomes and survival rates were compared using propensity score matching to minimize selection bias. Results Neoadjuvant therapy showed significantly longer 75% OS (72.7 months vs. 28.3 months, p = 0.032) and PFS (29.6 months vs. 13.2 months, p < 0.001) compared to upfront surgery. Additionally, neoadjuvant therapy demonstrated significant improvements in surgical outcomes, including higher R0 resection rates (74.3% vs. 49.5%, p = 0.034), reduced tumor size (22.0 mm vs. 28.0 mm, p = 0.001), and decreased lymphovascular invasion (20.0% vs. 52.4%, p = 0.001). Conclusion Our study demonstrates the potential benefits of neoadjuvant therapy for resectable PDAC. The improved survival rates, delayed disease progression, and enhanced surgical outcomes underscore the potential of neoadjuvant therapy in addressing this aggressive disease. Despite limitations such as the retrospective design and small sample size, these findings support the effectiveness of neoadjuvant therapy in improving treatment outcomes for PDAC patients in real‐world settings. Further prospective studies are required to validate these results.https://doi.org/10.1002/cam4.70363long‐term resultsneoadjuvant therapyoverall survivalpancreatic neoplasmprogression‐free survival |
| spellingShingle | Kyung In Shin Min Sung Yoon Jee Hoon Kim Won Joon Jang Galam Leem Jung Hyun Jo Moon Jae Chung Jeong Youp Park Seung Woo Park Ho Kyoung Hwang Chang Moo Kang Seung‐seob Kim Mi‐Suk Park Hee Seung Lee Seungmin Bang Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma Cancer Medicine long‐term results neoadjuvant therapy overall survival pancreatic neoplasm progression‐free survival |
| title | Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma |
| title_full | Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma |
| title_fullStr | Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma |
| title_full_unstemmed | Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma |
| title_short | Long‐Term Outcomes of Neoadjuvant Therapy Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma |
| title_sort | long term outcomes of neoadjuvant therapy versus upfront surgery for resectable pancreatic ductal adenocarcinoma |
| topic | long‐term results neoadjuvant therapy overall survival pancreatic neoplasm progression‐free survival |
| url | https://doi.org/10.1002/cam4.70363 |
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