Woohyung Lee1,2, Yoo-Seok Yoon3, Ho-Seong Han1, Jin Young Jang4, Jai Young Cho1, Woohyun Jung4, Wooil Kwon4, YoungRok Choi1, Sun-Whe Kim4. 1. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea. 2. Department of Surgery, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea. 3. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea. yoonys@snubh.org. 4. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: Although the role of adjuvant therapy in patients with pancreatic ductal adenocarcinoma (PDAC) is well established, its optimal timing and duration are still controversial. METHODS: The study included 311 patients with PDAC who underwent curative resection followed by adjuvant therapy. We analyzed survival data according to the timing of initiation and completion of adjuvant therapy. RESULTS: There were no differences in 5-year overall survival (OS) (32.8 vs. 35.4%, p = 0.539) and disease-free survival (DFS) rates (26.2 vs. 23.3%, p = 0.865) between early (≤6 weeks) and late (>6 weeks) initiation of adjuvant therapy. However, the 5-year OS (42.6 vs. 22.2%, p < 0.001) and DFS (29.2 vs. 18.4%, p = 0.042) rates were significantly greater in patients with complete versus incomplete adjuvant therapy. Multivariable analysis revealed that incomplete adjuvant therapy was an independent prognostic factor for decreased OS (p = 0.001; hazard ratio 1.850; 95% confidence interval 1.266-2.702). CONCLUSIONS: The results show that complete adjuvant therapy is a more important prognostic factor than early initiation for improving the survival of patients with resected PDAC.
BACKGROUND: Although the role of adjuvant therapy in patients with pancreatic ductal adenocarcinoma (PDAC) is well established, its optimal timing and duration are still controversial. METHODS: The study included 311 patients with PDAC who underwent curative resection followed by adjuvant therapy. We analyzed survival data according to the timing of initiation and completion of adjuvant therapy. RESULTS: There were no differences in 5-year overall survival (OS) (32.8 vs. 35.4%, p = 0.539) and disease-free survival (DFS) rates (26.2 vs. 23.3%, p = 0.865) between early (≤6 weeks) and late (>6 weeks) initiation of adjuvant therapy. However, the 5-year OS (42.6 vs. 22.2%, p < 0.001) and DFS (29.2 vs. 18.4%, p = 0.042) rates were significantly greater in patients with complete versus incomplete adjuvant therapy. Multivariable analysis revealed that incomplete adjuvant therapy was an independent prognostic factor for decreased OS (p = 0.001; hazard ratio 1.850; 95% confidence interval 1.266-2.702). CONCLUSIONS: The results show that complete adjuvant therapy is a more important prognostic factor than early initiation for improving the survival of patients with resected PDAC.
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