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Neoadjuvant Therapy Is Associated with Improved Chemotherapy Delivery and Overall Survival Compared to Upfront Resection in Pancreatic Cancer without Increasing Perioperative Complications.

Deig, Christopher Ryan and Sutton, Thomas Lee and Beneville, Blake and Trone, Kristin and Stratton, Amanda and Gunesch, Ali N and Liu, Amy Ivy and Alrohaibani, Alaaeddin and Mohebnasab, Maedeh and Bassale, Solange and Grossblatt-Wait, Alison and Keith, Dove and Attia, Fouad and Gilbert, Erin W and Lopez, Charles D and Kardosh, Adel and Chen, Emerson Y and Bensch, Kenneth G and Nabavizadeh, Nima and Thomas, Charles R and Mayo, Skye C and Sheppard, Brett C and Grossberg, Aaron (2022) Neoadjuvant Therapy Is Associated with Improved Chemotherapy Delivery and Overall Survival Compared to Upfront Resection in Pancreatic Cancer without Increasing Perioperative Complications. Cancers (Basel), 14 (3). ISSN 2072-6694

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Abstract

The role of neoadjuvant chemoradiotherapy and/or chemotherapy (neoCHT) in patients with pancreatic ductal adenocarcinoma (PDAC) is poorly defined. We hypothesized that patients who underwent neoadjuvant therapy (NAT) would have improved systemic therapy delivery, as well as comparable perioperative complications, compared to patients undergoing upfront resection. This is an IRB-approved retrospective study of potentially resectable PDAC patients treated within an academic quaternary referral center between 2011 and 2018. Data were abstracted from the electronic medical record using an institutional cancer registry and the National Surgical Quality Improvement Program. Three hundred and fourteen patients were eligible for analysis and eighty-one patients received NAT. The median overall survival (OS) was significantly improved in patients who received NAT (28.6 vs. 20.1 months, p = 0.014). Patients receiving neoCHT had an overall increased mean duration of systemic therapy (p < 0.001), and the median OS improved with each month of chemotherapy delivered (HR = 0.81 per month CHT, 95% CI (0.76-0.86), p < 0.001). NAT was not associated with increases in early severe post-operative complications (p = 0.47), late leaks (p = 0.23), or 30-90 day readmissions (p = 0.084). Our results show improved OS in patients who received NAT, driven largely by improved chemotherapy delivery, without an apparent increase in early or late perioperative complications compared to patients undergoing upfront resection.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Deig, Christopher Ryan
Sutton, Thomas Lee
Beneville, Blake
Trone, Kristin
Stratton, Amanda
Gunesch, Ali N
Liu, Amy Ivy
Alrohaibani, Alaaeddin
Mohebnasab, MaedehMAM1236@pitt.eduMAM12360000-0001-6623-9514
Bassale, Solange
Grossblatt-Wait, Alison
Keith, Dove
Attia, Fouad
Gilbert, Erin W
Lopez, Charles D
Kardosh, Adel
Chen, Emerson Y
Bensch, Kenneth G
Nabavizadeh, Nima
Thomas, Charles R
Mayo, Skye C
Sheppard, Brett C
Grossberg, Aaron
Date: 23 January 2022
Date Type: Acceptance
Journal or Publication Title: Cancers (Basel)
Volume: 14
Number: 3
DOI or Unique Handle: 10.3390/cancers14030609
Schools and Programs: School of Medicine > Pathology
Refereed: Yes
Uncontrolled Keywords: neoadjuvant therapy, pancreatic ductal adenocarcinoma, perioperative complications
ISSN: 2072-6694
Funders: NCI NIH HHS (K08 CA245188), NCI NIH HHS (CA245188)
Date Deposited: 29 Aug 2022 17:13
Last Modified: 30 Aug 2022 14:55
URI: http://d-scholarship.pitt.edu/id/eprint/43670

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