Evidence map›Paper›PMID 36804826›Full record

ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2023

No survival benefit with suboptimal CA19-9 response: defining effective neoadjuvant chemotherapy in resectable or borderline resectable pancreatic cancer.

Hao Liu, Mark D'Alesio, Samer AlMasri, Abdulrahman Hammad, Annissa Desilva, Steven Lebowitz, Caroline Rieser, Eishan Ashwat, Erica Hampton, Hussein Khachfe and 6 more

Open access · bronzeAbstract read
In one paragraph

Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.3field-weighted citation impact, top 11% 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

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
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

16 authors at 3 institutions in 1 country.

Hao LiuDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Mark D'AlesioSchool of Medicine, University of Pittsburgh, United States.
Samer AlMasriDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Abdulrahman HammadDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Annissa DesilvaDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Steven LebowitzSchool of Medicine, University of Pittsburgh, United States.
Caroline RieserDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Eishan AshwatSchool of Medicine, University of Pittsburgh, United States.
Erica HamptonSchool of Medicine, University of Pittsburgh, United States.
Hussein KhachfeDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Mckenna LaffeySchool of Medicine, University of Pittsburgh, United States.
Aatur SinghiDepartment of Pathology, University of Pittsburgh Medical Center, United States.
Nathan BaharyDepartment of Medicine, University of Pittsburgh Medical Center, United States.
Kenneth LeeDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Amer ZureikatDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States.
Alessandro PanicciaDepartment of Surgery, University of Pittsburgh Medical Center (UPMC), United States. Electronic address: panicciaa2@upmc.edu.
University of Pittsburgh Medical Center · USUniversity of Pittsburgh · USUPMC Health System · US

Funding

VECTOR CORE FACILITYP30CA047904 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CHRISTOPHER J. BAKKENIST · 1988 to 2026
$158.0M
NCI NIH HHS P30 CA047904
6 · The paper itself

Abstract

background/purposeNeoadjuvant chemotherapy (NAC) is gaining popularity over a surgery-first (SF) approach in treating resectable and borderline resectable pancreatic ductal adenocarcinoma (PDAC). However, what constitutes effective neoadjuvant chemotherapy is unknown.

methodsWe retrospectively analyzed resectable and borderline resectable PDAC patients who underwent pancreaticoduodenectomy (2010-2019) at a single institution. Optimal CA19-9 response was defined as normalization AND >50% reduction. We utilized Kaplan-Meier and multivariable-adjusted Cox models and competing risk subdistribution methods for statistical analysis.

results586 patients were included in this study. The multivariable-adjusted analysis demonstrated OS benefit in the NAC group only when OS was calculated from diagnosis (HR = 0.72, p = 0.02), but not from surgery (HR = 0.81, p = 0.1). However, in 59 patients who achieved optimal CA19-9 response, OS is significantly longer than the 134 patients with suboptimal CA19-9 response (39.3 m vs. 21.5 m, p = 0.005) or the 117 SF patients (39.3 m vs. 19.5 m, p < 0.001). Notably, a suboptimal CA19-9 response conferred no OS advantage compared to SF patients. The accumulative incidence of liver metastases (but not other metastases) was significantly reduced only in patients with optimal CA19-9 response to NAC (multivariable-adjusted subdistribution HR = 0.26, p = 0.03).

conclusionCA19-9 response to NAC may serve as the marker for effective NAC. These findings warrant validation in a multi-institutional study.

Indexed as

Carcinoma, Pancreatic DuctalPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsCA-19-9 AntigenHumansNeoadjuvant TherapyRetrospective StudiesCA-19-9 Antigen

Identifiers

PMID36804826
PMCPMC11232030
OpenAlexW4318940473

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.