Katherine T Ostapoff1, Emmanuel Gabriel1, Kristopher Attwood2, Boris W Kuvshinoff1, Steven J Nurkin1, Steven N Hochwald3. 1. Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. 2. Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. 3. Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. Electronic address: steven.hochwald@roswellpark.org.
Abstract
BACKGROUND: Current guidelines recommend adjuvant chemotherapy for resected pancreatic adenocarcinoma (PDAC). However, no studies have addressed its survival benefit for stage I patients as they comprise <10% of PDAC. METHODS: Using the NCDB 2006-2012, resected PDAC patients with stage I disease who received adjuvant therapy (chemotherapy or chemoradiation) were analyzed. Factors associated with overall survival (OS) were identified. RESULTS: 3909 patients with resected stage IA or IB PDAC were identified. Median OS was 60.3 months (mo) for stage IA and 36.9 mo for IB. 45.5% received adjuvant chemotherapy; 19.9% received adjuvant chemoradiation. There was OS benefit for both stage IA/IB patients with adjuvant chemotherapy (HR = 0.73 and 0.76 for IA and IB, respectively, p = 0.002 and <0.001). For patients with Stage IA disease (n = 1,477, 37.8%), age ≥70 (p < 0.001), higher grade (p < 0.001), ≤10 lymph nodes examined (p = 0.008), positive margins (p < 0.001), and receipt of adjuvant chemoradiation (p = 0.002) were associated with worse OS. For stage IB patients (n = 2,432, 62.2%), similar associations were observed with the exception of adjuvant chemoradiation whereby there was no significant association (p = 0.35). CONCLUSION: Adjuvant chemotherapy was associated with an OS benefit for patients with stage I PDAC; adjuvant chemoradiation was either of no benefit or associated with worse OS.
BACKGROUND: Current guidelines recommend adjuvant chemotherapy for resected pancreatic adenocarcinoma (PDAC). However, no studies have addressed its survival benefit for stage I patients as they comprise <10% of PDAC. METHODS: Using the NCDB 2006-2012, resected PDACpatients with stage I disease who received adjuvant therapy (chemotherapy or chemoradiation) were analyzed. Factors associated with overall survival (OS) were identified. RESULTS: 3909 patients with resected stage IA or IB PDAC were identified. Median OS was 60.3 months (mo) for stage IA and 36.9 mo for IB. 45.5% received adjuvant chemotherapy; 19.9% received adjuvant chemoradiation. There was OS benefit for both stage IA/IB patients with adjuvant chemotherapy (HR = 0.73 and 0.76 for IA and IB, respectively, p = 0.002 and <0.001). For patients with Stage IA disease (n = 1,477, 37.8%), age ≥70 (p < 0.001), higher grade (p < 0.001), ≤10 lymph nodes examined (p = 0.008), positive margins (p < 0.001), and receipt of adjuvant chemoradiation (p = 0.002) were associated with worse OS. For stage IB patients (n = 2,432, 62.2%), similar associations were observed with the exception of adjuvant chemoradiation whereby there was no significant association (p = 0.35). CONCLUSION: Adjuvant chemotherapy was associated with an OS benefit for patients with stage I PDAC; adjuvant chemoradiation was either of no benefit or associated with worse OS.
Authors: V O Oria; P Bronsert; A R Thomsen; M C Föll; C Zamboglou; Luciana Hannibal; S Behringer; M L Biniossek; C Schreiber; A L Grosu; L Bolm; D Rades; T Keck; M Werner; U F Wellner; O Schilling Journal: Transl Oncol Date: 2018-08-30 Impact factor: 4.243
Authors: John R Bergquist; Cornelius A Thiels; Christopher R Shubert; Tommy Ivanics; Elizabeth B Habermann; Santhi S Vege; Travis E Grotz; Sean P Cleary; Rory L Smoot; Michael L Kendrick; David M Nagorney; Mark J Truty Journal: Cancer Med Date: 2021-07-21 Impact factor: 4.452