Defining the optimal timing of adjuvant therapy for resected pancreatic adenocarcinoma: A statewide cancer registry analysis

Hayder Saeed, Dima Hnoosh, Bin Huang, Eric B. Durbin, Patrick C. Mcgrath, Philip Desimone, Erin Maynard, Lowell B. Anthony, Sean P. Dineen, Peter Hosein, Ching Wei D. Tzeng

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Long-term results of the ESPAC-3 trial suggest that while completing adjuvant therapy (AT) is necessary after resection of pancreatic ductal adenocarcinoma (PDAC), early initiation (within 8 weeks) may not be associated with improved overall survival (OS). The primary aim of this study was to evaluate the OS impact of early versus late AT in a statewide analysis. Methods: Patients with stages I–III PDAC in the Kentucky Cancer Registry (KCR) from 2004 to 2013, were evaluated. Those undergoing pancreatectomy were stratified into two groups (“early,” <8 weeks, vs. “late,” 8–16 weeks). Results: Of 2,221 diagnosed patients with stages I–III, 831 (37.4%) underwent pancreatectomy upfront. Of these, only 420 (50.5%) received AT. Initiation date of AT was not associated with OS (median OS: early, 20.2 vs. late, 19.0 months, P¼0.97). On multivariate analysis, factors that affected OS included stage (II, HR-1.82, P¼0.017; III, HR-3.77, P<0.001), node positivity (HR-1.51, P¼0.004), poorly/undifferentiated grade (HR-1.34; P¼0.011), but not AT initiation date. Conclusions: In this statewide analysis, there was no difference in OS between early and late AT initiation for resected PDAC. The ideal window for AT initiation remains unknown as tumor biology continues to trump regimens from the past decade.

Original languageEnglish (US)
Pages (from-to)451-455
Number of pages5
JournalJournal of Surgical Oncology
Volume114
Issue number4
DOIs
StatePublished - Sep 15 2016
Externally publishedYes

Keywords

  • Adjuvant therapy
  • Delay
  • Pancreatic adenocarcinoma
  • Pancreatic cancer
  • Timing

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Saeed, H., Hnoosh, D., Huang, B., Durbin, E. B., Mcgrath, P. C., Desimone, P., Maynard, E., Anthony, L. B., Dineen, S. P., Hosein, P., & D. Tzeng, C. W. (2016). Defining the optimal timing of adjuvant therapy for resected pancreatic adenocarcinoma: A statewide cancer registry analysis. Journal of Surgical Oncology, 114(4), 451-455. https://doi.org/10.1002/jso.24314