The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection

Daniel J. Kagedan, Ravish S. Raju, Matthew E. Dixon, Elizabeth Shin, Qing Li, Ning Liu, Maryam Elmi, Abraham El-Sedfy, Lawrence Paszat, Alexander Kiss, Craig C. Earle, Nicole Mittmann, Natalie G. Coburn

Resultado de la investigación: Articlerevisión exhaustiva

6 Citas (Scopus)

Resumen

Background Using a retrospective observational cohort approach, the overall survival (OS) following curative-intent resection of pancreatic adenocarcinoma (PC) was defined at the population level according to adjuvant treatment, and predictors of OS were identified. Methods Patients undergoing resection of PC in the province of Ontario between 2005 and 2010 were identified using the provincial cancer registry, and linked to databases that include all treatments received and outcomes experienced in the province. Pathology reports were abstracted for staging and margin status. Patients were identified as having received chemotherapy (CT), chemoradiation therapy (CRT), or no adjuvant treatment (NAT). Kaplan–Meier survival analysis of patients surviving ≥6 months was performed, and predictors of OS identified by log-rank test. Cox multivariable analysis was used to define independent predictors of OS. Results Among the 473 patients undergoing PC resection, the median survival was 17.8 months; for the 397 who survived ≥6 months following surgery, the 5-year OS for the CT, CRT, and NAT groups was 21%, 16%, and 17%, respectively (p = 0.584). Lymph node-negative patients demonstrated improved OS associated with chemotherapy on multivariable analysis (HR = 2.20, 95% CI = 1.25–3.83 for NAT vs. CT). Conclusions Following PC resection, only patients with negative lymph nodes demonstrated improved OS associated with adjuvant chemotherapy.

Idioma originalEnglish (US)
Páginas (desde-hasta)339-347
Número de páginas9
PublicaciónHPB
Volumen18
N.º4
DOI
EstadoPublished - 2016
Publicado de forma externa

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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