ArticleJournal of surgical oncology2022
Total neoadjuvant therapy is associated with improved overall survival and pathologic response in pancreatic adenocarcinoma.
Article in Journal of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Review
- Clinical Significance of an R1 Resection for Pancreatic Ductal Adenocarcinomas Treated by Intensive FOLFIRINOX Induction-Based Chemotherapy and Extended Pancreatectomies.Annals of surgical oncology · 2026Article
- Pulsed Low-Dose-Rate Chemoradiation Induces Stromal Reprogramming in Pancreatic CAF-Generated ECM: Quantification by the HOST-Factor.Gastro hep advances · 2026Article
- Complete Pathological Response to Neoadjuvant Treatment in Pancreatic Ductal Adenocarcinoma-Can We Achieve a Long-Term Survival? A Narrative Review.Life (Basel, Switzerland) · 2025Review
- Neoadjuvant Therapy in Pancreatic Ductal Adenocarcinoma: Aligning Guideline Recommendations with Real-World Evidence.Cancers · 2025Article
- Prognosis Associated with Complete Pathological Response Following Neoadjuvant Treatment for PancreaTic AdenOcarciNOma in the FOFLIRINOX Era: the Multicenter TONO Study.Annals of surgical oncology · 2025Article
- Article
- Pathological Complete Response in Patients With Resected Pancreatic Adenocarcinoma After Preoperative Chemotherapy.JAMA network open · 2024Observational
- Neoadjuvant Chemotherapy is Associated with Increased Risk of Postoperative DVT After Distal Pancreatectomy for Pancreatic Adenocarcinoma: a NSQIP Analysis.Annals of surgical oncology · 2024Article
- Changes in Oncological Surgical Principles Driven by Advances in Preoperative Treatments.Therapeutics and clinical risk management · 2023Article
- Prognostic Impact of Resection Margin Status on Distal Pancreatectomy for Ductal Adenocarcinoma.Current oncology (Toronto, Ont.) · 2022Review
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Authors and funding
7 authors.
Funding
Abstract
backgroundFew studies have evaluated outcomes of total neoadjuvant therapy (TNT) compared with single modality neoadjuvant therapy (SMNT) or surgery first (SF) for pancreatic ductal adenocarcinoma (PDAC).
methodsA single-institution retrospective review of PDAC patients who underwent pancreatectomy was conducted (1993-2019). Overall survival (OS) estimates from diagnosis and from surgery were determined using Kaplan-Meier methods; Cox proportional hazards models adjusted for covariates.
resultsSurgery was performed upfront (SF) in 168 (46.9%), while 111 (31.0%) had chemotherapy or chemoradiation before resection (SMNT), and 79 (22.1%) underwent TNT (chemotherapy and chemoradiation). Resection margins were more frequently R0 in the TNT group (86.1%) compared with SMNT (64.0%) and SF (72%) (p < 0.001). Complete pathologic response was more common in the TNT group (10.1%) compared with SMNT (3.6%) or SF (0.6%) (p = 0.001), resulting in prolonged survival (median OS = 100.2 months). TNT patients demonstrated longer median OS from surgery (33.6 months) compared with SF (19.1 months) and SMNT (17.4 months) (p = 0.010), which persisted after controlling for covariates.
conclusionsTNT is associated with more frequent complete pathologic response, a higher rate of margin negative resection, and prolonged OS as compared with SF or SMNT. Additional studies to identify subgroups that derive the greatest benefit are warranted.
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