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

Authors
 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 
Citation
 CANCER MEDICINE, Vol.13(22) : e70363, 2024-11 
Journal Title
CANCER MEDICINE
Issue Date
2024-11
MeSH
Aged ; Carcinoma, Pancreatic Ductal* / mortality ; Carcinoma, Pancreatic Ductal* / pathology ; Carcinoma, Pancreatic Ductal* / surgery ; Carcinoma, Pancreatic Ductal* / therapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy* / methods ; Pancreatectomy ; Pancreatic Neoplasms* / mortality ; Pancreatic Neoplasms* / pathology ; Pancreatic Neoplasms* / surgery ; Pancreatic Neoplasms* / therapy ; Propensity Score ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Keywords
long‐term results ; neoadjuvant therapy ; overall survival ; pancreatic neoplasm ; progression‐free survival
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.
Files in This Item:
T202407215.pdf Download
DOI
10.1002/cam4.70363
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Jee Hoon(김지훈)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
Leem, Ga Lam(임가람) ORCID logo https://orcid.org/0000-0001-6490-0911
Jang, Wonjoon(장원준)
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Jo, Jung Hyun(조중현) ORCID logo https://orcid.org/0000-0002-2641-8873
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201430
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