Optimal timing and treatment strategy for pancreatic cancer.

ABSTRACT: BACKGROUND:For pancreatic adenocarcinoma (PDAC), no studies have established any association between earlier treatment initiation and long-term outcomes. In addition, an optimal type of initial treatment for the localized disease remains ill-defined. METHODS:Patients in the National Cancer Database (2004-2015) with clinical stage I (CS-I) and II (CS-II) PDAC who underwent curative-intent resection were included. Optimal time from diagnosis-to-treatment including neoadjuvant chemotherapy, neoadjuvant chemoradiation, or upfront surgery was assessed. An optimal type of treatment was evaluated. The primary outcome was overall survival (OS). RESULTS:Among 29?167 patients, starting any treatment within 0 to 6 weeks was associated with improved median OS compared with 7 to 12 weeks (21.0 vs 20.1 months; P?=?.004). This persisted when accounting for sex, race, and Charlson-Deyo score (hazard ratio [HR], 0.94; P?=?0.02) and on subset analysis for CS-I (23.5 vs 21.8 months; P?=?.04) and CS-II (19.4 vs 18.3 months; P?=?.03). Neoadjuvant chemotherapy was associated with improved OS compared with neoadjuvant chemoradiation (25.6 vs 22.7 months; P?

SUBMITTER: Gamboa AC 

PROVIDER: S-EPMC7396281 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature