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Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients.

Publication ,  Conference
Youngwirth, LM; Nussbaum, DP; Thomas, S; Adam, MA; Blazer, DG; Roman, SA; Sosa, JA
Published in: J Surg Oncol
August 2017

BACKGROUND: Neoadjuvant therapy has theoretical benefits for pancreatic cancer; however, its association with perioperative outcomes remains controversial. This study sought to evaluate variation in use of neoadjuvant therapy and outcomes following pancreatic resection. METHODS: The National Cancer Data Base (1998-2011) was queried for patients with Stage I or II pancreatic adenocarcinoma who underwent pancreaticoduodenectomy. Subjects were classified by use of neoadjuvant chemotherapy and/or radiation therapy. Factors associated with use of neoadjuvant therapy were evaluated, and outcomes were compared. RESULTS: A 18 243 patients were identified; 1375 (7.5%) received neoadjuvant therapy. From 1998 to 2011, use of neoadjuvant therapy increased from 4.3% to 17.0%. Patients receiving neoadjuvant therapy were younger (63.1 vs 66.1 years, P = 0.001) and more likely to receive treatment at an academic facility (64.4% vs 51.4%, P < 0.001). Patients who received neoadjuvant therapy were more likely to have negative margins (77.8% vs 85.5%), negative lymph nodes (42.9% vs 59.3%) and tumors confined to the pancreas (65.8% vs 70.6%, all P < 0.001). Patients receiving neoadjuvant therapy had lower 30-day mortality (2.0% vs 4.6%, P < 0.001) and readmission rates (7.4% vs 9.5%, P = 0.02). CONCLUSIONS: Neoadjuvant therapy use is increasing and associated with comparable short-term outcomes. Further studies are needed to identify patients who would benefit from neoadjuvant therapy.

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Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

August 2017

Volume

116

Issue

2

Start / End Page

127 / 132

Location

United States

Related Subject Headings

  • United States
  • Radiotherapy, Adjuvant
  • Patient Readmission
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Margins of Excision
  • Male
 

Citation

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ICMJE
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Youngwirth, L. M., Nussbaum, D. P., Thomas, S., Adam, M. A., Blazer, D. G., Roman, S. A., & Sosa, J. A. (2017). Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients. In J Surg Oncol (Vol. 116, pp. 127–132). United States. https://doi.org/10.1002/jso.24630
Youngwirth, Linda M., Daniel P. Nussbaum, Samantha Thomas, Mohamed A. Adam, Dan G. Blazer, Sanziana A. Roman, and Julie A. Sosa. “Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients.” In J Surg Oncol, 116:127–32, 2017. https://doi.org/10.1002/jso.24630.
Youngwirth LM, Nussbaum DP, Thomas S, Adam MA, Blazer DG, Roman SA, et al. Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients. In: J Surg Oncol. 2017. p. 127–32.
Youngwirth, Linda M., et al. “Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients.J Surg Oncol, vol. 116, no. 2, 2017, pp. 127–32. Pubmed, doi:10.1002/jso.24630.
Youngwirth LM, Nussbaum DP, Thomas S, Adam MA, Blazer DG, Roman SA, Sosa JA. Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients. J Surg Oncol. 2017. p. 127–132.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

August 2017

Volume

116

Issue

2

Start / End Page

127 / 132

Location

United States

Related Subject Headings

  • United States
  • Radiotherapy, Adjuvant
  • Patient Readmission
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Margins of Excision
  • Male