SynthesisESMO open2023
Does neoadjuvant treatment in resectable pancreatic cancer improve overall survival? A systematic review and meta-analysis of randomized controlled trials.
Synthesis in ESMO open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Pooled it
- Evaluating the benefits of adjuvant chemotherapy in patients with pancreatic cancer undergoing radical pancreatectomy after neoadjuvant therapy-a systematic review and meta-analysis.Frontiers in oncology · 2024Pooled it
- Comparison of neoadjuvant therapy versus upfront surgery in resectable pancreatic adenocarcinoma: a retrospective study.Annals of medicine and surgery (2012) · 2026Article
- Benefit of Adjuvant Therapy After Neoadjuvant Therapy and Resection for Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2026Article
- Does neoadjuvant therapy reduce pancreatic fistula after pancreatoduodenectomy and distal pancreatectomy?-a systematic review and meta-analysis.Hepatobiliary surgery and nutrition · 2026Article
- Synchronous Isolated Cystic Pancreatic Metastasis Arising From Primary Colorectal Cancer: A Rare Case Report.The American journal of case reports · 2026Article
- Upfront Chemotherapy Versus Immediate Surgery for Operable Pancreatic Cancer: An Umbrella Review of Meta-Analyses.Cancers · 2026Review
- Article
- Laparoscopic pancreatoduodenectomy and venous resection are safe in selected patients: a monocentric comparative study in 30 patients.Surgical endoscopy · 2026Article
- Limited benefits of neoadjuvant therapy on R0 resection rate and overall survival in patients with resectable or locally advanced PDAC in randomized controlled trials.Frontiers in medicine · 2026Review
- A risk score system including CT features for predicting early recurrence of resectable pancreatic ductal adenocarcinoma after radical resection: a dual-center retrospective study.European radiology · 2025Article
- Impact of Tumor Localization on Early Recurrence After Curative Resection in Pancreatic Ductal Adenocarcinoma.Medicina (Kaunas, Lithuania) · 2025Article
- Letter to the Editor of Annals of Surgical Oncology Concerning "Dissecting Tumor Size Underestimation in Pancreatic Cancer: A Comparative Analysis of Preoperative Treatments".Annals of surgical oncology · 2025Article
- Neoadjuvant treatment in resectable pancreatic cancer: Why is upfront surgery so hard to be beaten?World journal of clinical oncology · 2025Review
- Review
- Advances in the Management of Pancreatic Cancer: Current Strategies and Emerging Therapies.International journal of molecular sciences · 2025Review
- Pancreatic Cancer: Pathogenesis and Clinical Studies.MedComm · 2025Review
- Survival Outcomes in Nonmetastatic pT4 Pancreatic Ductal Adenocarcinoma: A SEER Database Analysis Comparing Neoadjuvant Therapy and Upfront Surgery with Propensity Score Matching.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Adjuvant Chemotherapy After Resection of Localized Pancreatic Adenocarcinoma Following Preoperative FOLFIRINOX.JAMA oncology · 2025Article
- Epithelial-Mesenchymal Transition Suppression by ML210 Enhances Gemcitabine Anti-Tumor Effects on PDAC Cells.Biomolecules · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeoadjuvant chemotherapy may improve overall survival (OS) in 'borderline' resectable pancreatic cancer (RPC). Whether the results are the same in upfront RPC is unknown. MATERIALS AND
methodsTo evaluate the association of neoadjuvant treatment and survival outcomes in RPC, a systematic literature review was carried out including prospective randomized trials of neoadjuvant treatment versus upfront surgery. Articles indexed in PubMed, Embase and Scopus were evaluated. Data regarding systemic treatment regimens, R0 resection rates, disease-free survival (DFS) and OS were extracted. The outcomes were compared using a random-effects model. The index I
resultsOf 3229 abstracts, 6 randomized controlled trials were considered eligible with a combined sample size of 805 RPC patients. Among the trials, PACT-15, PREP-02/JSAP-05 and updated long-term results from PREOPANC and NEONAX trials were included. Combining the studies with meta-analysis, we could see that neoadjuvant treatment in RPC does not improve DFS [hazard ratio (HR) 0.71 (0.46-1.09)] or OS [HR 0.76 (0.52-1.11)], without significant heterogeneity. Interestingly, R0 rates improved ∼20% with the neoadjuvant approach [HR 1.2 (1.04-1.37)]. It is important to note that most studies evaluated gemcitabine-based regimens in the neoadjuvant setting.
conclusionsNeoadjuvant chemotherapy or chemoradiation does not improve DFS or OS in RPC compared to upfront surgery followed by adjuvant treatment. Neoadjuvant treatment improves R0 rates by ∼20%. Randomized ongoing trials are eagerly awaited with more active combined regimens including modified FOLFIRINOX.
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What OpenQuestion holds
Registered trials
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.