The Impact of Prolonged Chemotherapy to Surgery Interval and Neoadjuvant Radiotherapy on Pathological Complete Response and Overall Survival in Pancreatic Cancer Patients

Basem Azab, Francisco Igor Macedo, David Chang, Caroline Ripat, Dido Franceschi, Alan S. Livingstone, Danny Yakoub

Research output: Contribution to journalArticle

Abstract

Background: We aimed to study the impact of neoadjuvant chemotherapy to surgery (NCT-S) interval and neoadjuvant radiotherapy (NRT) on pathological complete response (pCR) and overall survival (OS) in pancreatic cancer (pancreatic ductal adenocarcinoma [PDAC]). Methods: National Cancer Data Base (NCDB)–pancreatectomy patients who underwent NCT/NRT were included. The NCT-S interval was divided into time quintiles in weeks: 8 to 11, 12 to 14, 15 to 19, 20 to 29, and >29 weeks. Results: A total of 2093 patients with NCT were included with median follow-up of 74 months and 71% NRT. The pCR rate was 2.1% with higher median OS compared with non-pCR (41 vs 19 months, P =.03). The pCR rate increased with longer NCT-S interval (quintiles: 1%, 1.6%, 1.7%, 3%, and 6%, P <.001, respectively). In logistic regression, NRT (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 1.1-6.1, P =.03) and NCT-S >29 weeks (OR = 6.1, 95% CI = 2.02-18.50, P <.001) were predictive of increased pCR. The prolonged NCT-S interval and pCR were independent predictors of OS, whereas NRT was not. Conclusions: Longer NCT-S interval and pCR were independent predictors of improved OS in patients with PDAC. The NRT predicted increased pCR but not OS.

Original languageEnglish (US)
JournalClinical Medicine Insights: Oncology
Volume14
DOIs
StatePublished - 2020

Keywords

  • neoadjuvant chemoradiation
  • Pancreas cancer
  • pathological response
  • pCR
  • survival

ASJC Scopus subject areas

  • Oncology

Fingerprint Dive into the research topics of 'The Impact of Prolonged Chemotherapy to Surgery Interval and Neoadjuvant Radiotherapy on Pathological Complete Response and Overall Survival in Pancreatic Cancer Patients'. Together they form a unique fingerprint.

  • Cite this