Evidence map›Paper›PMID 35861852›Full record

ArticleWorld journal of surgery2022

Postoperative Chemotherapy is Associated with Improved Survival in Patients with Node-Positive Pancreatic Ductal Adenocarcinoma After Neoadjuvant Therapy.

Gabriel D Ivey, Sami Shoucair, Daniel J Delitto, Joseph R Habib, Benedict Kinny-Köster, Christopher R Shubert, Kelly J Lafaro, John L Cameron, William R Burns, Richard A Burkhart and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
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  5. Article
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Gabriel D Ivey *Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sami Shoucair *Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Daniel J DelittoDepartment of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Joseph R HabibDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Benedict Kinny-KösterDepartment of Surgery, NYU Grossman School of Medicine, New York, NY, USA.
Christopher R ShubertDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kelly J LafaroDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
John L CameronDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
William R BurnsDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Richard A BurkhartDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Elizabeth L ThompsonDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Amol NarangDepartment of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lei ZhengDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher L WolfgangDepartment of Surgery, NYU Grossman School of Medicine, New York, NY, USA.
Jin HeDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jhe11@jhmi.edu.
Johns Hopkins Medicine · USJohns Hopkins University · USNew York University · USStanford University · US

Funding

Tumor Antigens for Individual Signatures and TherapyP50CA062924 · NCI · JOHNS HOPKINS UNIVERSITY · PI JAFFEE, ELIZABETH M. · 1993 to 2022
$54.6M
Transforming Human Pancreatic Cancer Into An Immunologic DiseaseP01CA247886 · NCI · JOHNS HOPKINS UNIVERSITY · PI ANDERS, ROBERT A. · 2021 to 2025
$12.7M
Targeting the Immunosuppressive Tumor Microenvironment of Pancreatic Cancer with a Neoadjuvant Platform Clinical TrialR01CA197296 · NCI · JOHNS HOPKINS UNIVERSITY · PI William Reece Burns, Eric Christenson · 2015 to 2026
$5.7M
NCI NIH HHS P01 CA247886NCI NIH HHS P50 CA062924NCI NIH HHS R01 CA197296
6 · The paper itself

Abstract

backgroundPostoperative chemotherapy following pancreatic cancer resection is the standard of care. The utility of postoperative chemotherapy for patients who receive neoadjuvant therapy (NAT) is unclear.

methodsPatients who underwent pancreatectomy after NAT with FOLFIRINOX or gemcitabine-based chemotherapy for non-metastatic pancreatic adenocarcinoma (2015-2019) were identified. Patients who received less than 2 months of neoadjuvant chemotherapy or died within 90 days from surgery were excluded.

resultsA total of 427 patients (resectable, 22.2%; borderline resectable, 37.9%; locally advanced, 39.8%) were identified with the majority (69.3%) receiving neoadjuvant FOLFIRINOX. Median duration of NAT was 4.1 months. Following resection, postoperative chemotherapy was associated with an improved median overall survival (OS) (28.7 vs. 20.4 months, P = 0.006). Risk-adjusted multivariable modeling showed negative nodal status (N0), favorable pathologic response (College of American Pathologists score 0 & 1), and receipt of postoperative chemotherapy to be independent predictors of improved OS. Regimen, duration, and number of cycles of NAT were not significant predictors. Thirty-four percent (60/176) of node-positive and 50.1% (126/251) of node-negative patients did not receive postoperative chemotherapy due to poor functional status, postoperative complications, and patient preference. Among patients with node-positive disease, postoperative chemotherapy was associated with improved median OS (27.2 vs. 10.5 months, P < 0.001). Among node-negative patients, postoperative chemotherapy was not associated with a survival benefit (median OS, 30.9 vs. 36.9 months; P = 0.406).

conclusionAlthough there is no standard NAT regimen for patients with pancreatic cancer, postoperative chemotherapy following NAT and resection appears to be associated with improved OS for patients with node-positive disease.

Indexed as

AdenocarcinomaCarcinoma, Pancreatic DuctalPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsHumansNeoadjuvant TherapyPancreatectomyRetrospective StudiesUronic AcidsN-acetyltalosaminuronic acidUronic Acids

Identifiers

PMID35861852
PMCPMC9532378
OpenAlexW4286490947

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.