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Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy.

Publication ,  Journal Article
Landa, K; Schmitz, R; Farrow, NE; Rushing, C; Niedzwiecki, D; Cerullo, M; Herbert, GS; Shah, KN; Zani, S; Blazer, DG; Allen, PJ; Lidsky, ME
Published in: HPB (Oxford)
July 2022

BACKGROUND: Standard of care for resectable pancreatic cancer is a combination of surgical resection (SR) and multiagent chemotherapy (MCT). We aim to determine whether SR or MCT is associated with superior survival for patients receiving only single-modality therapy. METHODS: Patients with stage I-IIb pancreatic head adenocarcinoma who received either MCT or SR were identified in the NCDB (2013-2015). Following a piecewise approach to estimating hazards over the course of follow-up, conditional overall survival (OS) at 30, 60, and 90 days after treatment initiation was estimated using landmark analyses. RESULTS: 3103 patients received MCT alone (60.3%) and 2043 underwent SR alone (39.7%). SR had an OS disadvantage at 30 (HR 3.99, 95% CI 3.12-5.11) and 60 days (HR 1.85, 95% CI 1.4-2.45), but an OS advantage after 90 days (HR 0.59, 95% CI 0.55-0.64). In a landmark analysis conditioned on 90 days survival post treatment initiation, median OS was improved for SR (17.0 vs. 12.2 months, p < 0.0001); SR improved 3-year OS by 21.3% (p < 0.05), despite patients being older (median 72 vs. 67 years, p < 0.0001) with higher Charlson-Deyo comorbidity scores (≥2: 11.2 vs. 8.6%, p = 0.006). CONCLUSION: For patients with resectable pancreatic cancer, SR is associated with superior long-term survival compared to MCT.

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Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

July 2022

Volume

24

Issue

7

Start / End Page

1153 / 1161

Location

England

Related Subject Headings

  • Surgery
  • Pancreatic Neoplasms
  • Humans
  • Antineoplastic Combined Chemotherapy Protocols
  • Adenocarcinoma
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

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MLA
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Landa, K., Schmitz, R., Farrow, N. E., Rushing, C., Niedzwiecki, D., Cerullo, M., … Lidsky, M. E. (2022). Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy. HPB (Oxford), 24(7), 1153–1161. https://doi.org/10.1016/j.hpb.2021.12.007
Landa, Karenia, Robin Schmitz, Norma E. Farrow, Christel Rushing, Donna Niedzwiecki, Marcelo Cerullo, Garth S. Herbert, et al. “Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy.HPB (Oxford) 24, no. 7 (July 2022): 1153–61. https://doi.org/10.1016/j.hpb.2021.12.007.
Landa K, Schmitz R, Farrow NE, Rushing C, Niedzwiecki D, Cerullo M, et al. Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy. HPB (Oxford). 2022 Jul;24(7):1153–61.
Landa, Karenia, et al. “Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy.HPB (Oxford), vol. 24, no. 7, July 2022, pp. 1153–61. Pubmed, doi:10.1016/j.hpb.2021.12.007.
Landa K, Schmitz R, Farrow NE, Rushing C, Niedzwiecki D, Cerullo M, Herbert GS, Shah KN, Zani S, Blazer DG, Allen PJ, Lidsky ME. Surgical resection is associated with improved long-term survival of patients with resectable pancreatic head cancer compared to multiagent chemotherapy. HPB (Oxford). 2022 Jul;24(7):1153–1161.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

July 2022

Volume

24

Issue

7

Start / End Page

1153 / 1161

Location

England

Related Subject Headings

  • Surgery
  • Pancreatic Neoplasms
  • Humans
  • Antineoplastic Combined Chemotherapy Protocols
  • Adenocarcinoma
  • 3202 Clinical sciences
  • 1103 Clinical Sciences