ArticleInternational journal of surgery (London, England)2023
The experience of neoadjuvant chemotherapy versus upfront surgery in resectable pancreatic cancer: a cross sectional study.
Article in International journal of surgery (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Clinical Outcomes of Neoadjuvant Therapy Versus Upfront Surgery in Resectable Pancreatic Cancer: Systematic Review and Meta-analysis of Latest Randomized Controlled Trials.Annals of surgical oncology · 2025Pooled it
- 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
- A New CA19-9 Cutoff Value Identifies Lewis Antigen Status and Refines Prognostic Stratification in PDAC.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Observational
- Survival benefits of neoadjuvant chemotherapy in advanced pancreatic cancer with vascular resection: who benefits the most? A study on key predictive factors.Updates in surgery · 2026Article
- Surgery in Older Cancer Patients.Current oncology reports · 2026Review
- Multiomics Analysis of Nucleotide Metabolism Highlights the Important Role of Adenylate Kinase 4 in Pancreatic Cancer.Human mutation · 2026Article
- The Palliation of Unresectable Pancreatic Cancer: Evolution from Surgery to Minimally Invasive Modalities.Journal of clinical medicine · 2025Review
- Single-cell RNA sequencing via endoscopic ultrasound-guided fine-needle biopsy for pancreatic tumors uncovered an aggressive subclone with a poor prognosis.ESMO gastrointestinal oncology · 2025Article
- Consensus, debate, and prospective on pancreatic cancer treatments.Journal of hematology & oncology · 2024Review
- Systemic treatments in pancreatic cancer: Taiwan pancreas society recommendation.Biomedical journal · 2024Review
- Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan.Journal of biomedical science · 2024Article
- Advanced pancreatic cancer with long-term recurrence-free survival after radical pancreatic resection and subsequent resection of lung metastases twice: A case report.International journal of surgery case reports · 2023Article
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUpfront resection (UR) followed by adjuvant chemotherapy remains the standard treatment for resectable pancreatic cancer. There is increasing evidence suggesting favourable outcomes toward neoadjuvant chemotherapy (NAC) followed by surgery.
methodsAll clinical staging with resectable pancreatic cancer patients treated at a tertiary medical centre from 2013 to 2020 were identified. The baseline characteristics, treatment course, surgery outcome and survival results of UR or NAC were compared.
resultsFinally, in 159 resectable patients, 46 patients (29%) underwent NAC and 113 patients (71%) received UR. In NAC, 11 patients (24%) did not receive resection, 4 (36.4%) for comorbidity, 2 (18.2%) for patient refusal and 2 (18.2%) for disease progression. In UR, 13 patients (12%) were unresectable intraoperatively; 6 (46.2%) for locally advanced and 5 (38.5%) for distant metastasis. Overall, 97% of patients in NAC and 58% of patients in UR completed adjuvant chemotherapy. As of data cut-off, 24 patients (69%) in NAC and 42 patients (29%) in UR were still tumour free. The median recurrence-free survival in NAC, UR with adjuvant chemotherapy and without adjuvant chemotherapy were 31.3 months (95% CI, 14.4-not estimable), 10.6 months (95% CI, 9.0-14.3) and 8.5 months (95% CI, 5.8-11.8), P =0.036; and the median overall survival in each group were not reached (95% CI, 29.7-not estimable), 25.9 months (95% CI, 21.1-40.5) and 21.7 months (12.0-32.8), P =0.0053. Based on initial clinical staging, the median overall survival of NAC was not significantly different from UR with a tumour less than or equal to 2 cm, P =0.29. NAC patients had a higher R0 resection rate (83% versus 53%), lower recurrence rate (31% versus 71%) and harvested median number lymph node (23 versus 15).
conclusionThis study demonstrates that NAC is superior to UR in resectable pancreatic cancer with better survival.
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