BACKGROUND: Neoadjuvant chemoradiation before surgery is an emerging treatment modality for pancreatic ductal adenocarcinoma (PDAC). However, analysis of prognostic factors is limited for patients with PDAC treated with neoadjuvant chemoradiation and pancreaticoduodenectomy (PD). METHODS: The study population was comprised of 240 consecutive patients with PDAC who received neoadjuvant chemoradiation and PD and was compared with 60 patients who had no neoadjuvant therapy between 1999 and 2007. Clinicopathologic features were correlated with disease-free survival (DFS) and overall survival (OS). RESULTS: Among the 240 treated patients, the 1-year and 3-year DFS rates were 52% and 32%, with a median DFS of 15.1 months. The 1-year and 3-year OS rates were 95% and 47%, with a median OS of 33.5 months. By univariate analysis, DFS was associated with age, post-therapy tumor stage (ypT), lymph node status (ypN), number of positive lymph nodes, and American Joint Committee on Cancer (AJCC) stage, whereas OS was associated with intraoperative blood loss, margin status, ypT, ypN, number of positive lymph nodes, and AJCC stage. By multivariate analysis, DFS was independently associated with age, number of positive lymph nodes, and AJCC stage, and OS was independently associated with differentiation, margin status, number of positive lymph nodes, and AJCC stage. In addition, the treated patients had better OS and lower frequency of lymph node metastasis than those who had no neoadjuvant therapy. CONCLUSIONS: In patients with PDAC who received neoadjuvant chemoradiation and subsequent PD, post-therapy pathologic AJCC stage and number of positive lymph nodes are independent prognostic factors.
BACKGROUND: Neoadjuvant chemoradiation before surgery is an emerging treatment modality for pancreatic ductal adenocarcinoma (PDAC). However, analysis of prognostic factors is limited for patients with PDAC treated with neoadjuvant chemoradiation and pancreaticoduodenectomy (PD). METHODS: The study population was comprised of 240 consecutive patients with PDAC who received neoadjuvant chemoradiation and PD and was compared with 60 patients who had no neoadjuvant therapy between 1999 and 2007. Clinicopathologic features were correlated with disease-free survival (DFS) and overall survival (OS). RESULTS: Among the 240 treated patients, the 1-year and 3-year DFS rates were 52% and 32%, with a median DFS of 15.1 months. The 1-year and 3-year OS rates were 95% and 47%, with a median OS of 33.5 months. By univariate analysis, DFS was associated with age, post-therapy tumor stage (ypT), lymph node status (ypN), number of positive lymph nodes, and American Joint Committee on Cancer (AJCC) stage, whereas OS was associated with intraoperative blood loss, margin status, ypT, ypN, number of positive lymph nodes, and AJCC stage. By multivariate analysis, DFS was independently associated with age, number of positive lymph nodes, and AJCC stage, and OS was independently associated with differentiation, margin status, number of positive lymph nodes, and AJCC stage. In addition, the treated patients had better OS and lower frequency of lymph node metastasis than those who had no neoadjuvant therapy. CONCLUSIONS: In patients with PDAC who received neoadjuvant chemoradiation and subsequent PD, post-therapy pathologic AJCC stage and number of positive lymph nodes are independent prognostic factors.
Authors: Deyali Chatterjee; Asif Rashid; Hua Wang; Matthew H Katz; Robert A Wolff; Gauri R Varadhachary; Jeffrey E Lee; Peter W Pisters; Henry F Gomez; James L Abbruzzese; Jason B Fleming; Huamin Wang Journal: Am J Surg Pathol Date: 2012-04 Impact factor: 6.394
Authors: Deyali Chatterjee; Matthew H Katz; Asif Rashid; Hua Wang; Alina C Iuga; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Peter W Pisters; Christopher H Crane; Henry F Gomez; James L Abbruzzese; Jason B Fleming; Huamin Wang Journal: Am J Surg Pathol Date: 2012-03 Impact factor: 6.394
Authors: Sun Mi Lee; Matthew H G Katz; Li Liu; Manonmani Sundar; Hua Wang; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Anirban Maitra; Jason B Fleming; Asif Rashid; Huamin Wang Journal: Am J Surg Pathol Date: 2016-12 Impact factor: 6.394
Authors: Deyali Chatterjee; Matthew H Katz; Asif Rashid; Jeannelyn S Estrella; Hua Wang; Gauri R Varadhachary; Robert A Wolff; Jeffrey E Lee; Peter W Pisters; James L Abbruzzese; Jason B Fleming; Huamin Wang Journal: Histopathology Date: 2013-09-20 Impact factor: 5.087
Authors: Reza Nejati; Jennifer B Goldstein; Daniel M Halperin; Hua Wang; Nazila Hejazi; Asif Rashid; Matthew H Katz; Jeffrey E Lee; Jason B Fleming; Jaime Rodriguez-Canales; Jorge Blando; Ignacio I Wistuba; Anirban Maitra; Robert A Wolff; Gauri R Varadhachary; Huamin Wang Journal: Pancreas Date: 2017-10 Impact factor: 3.327
Authors: Eric A Mellon; Tobin J Strom; Sarah E Hoffe; Jessica M Frakes; Gregory M Springett; Pamela J Hodul; Mokenge P Malafa; Michael D Chuong; Ravi Shridhar Journal: J Gastrointest Oncol Date: 2016-08