ArticleJournal of gastroenterology2023
Standard versus delayed initiation of S-1 adjuvant chemotherapy after surgery for pancreatic cancer: a secondary analysis of a nationwide cohort by the Japan Pancreas Society.
Article in Journal of gastroenterology, 2023. 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.
- Timing of Adjuvant S-1 Chemotherapy and Survival After Pancreatectomy for Pancreatic Cancer: An Ancillary Analysis of the JASPAC 01 Trial.Journal of hepato-biliary-pancreatic sciences · 2026Trial
- Trial
- Achievement of the Ideal Outcome After Pancreatectomy for Pancreatic Ductal Adenocarcinoma Is Associated With Earlier Initiation and Higher Completion Rates of Adjuvant Chemotherapy and Improved Long-Term Survival.Annals of gastroenterological surgery · 2026Article
- Neoadjuvant and adjuvant treatment for pancreatic ductal adenocarcinoma in patients over 80 years old based on a nationwide clinical database.Journal of gastroenterology · 2026Article
- Impact of preoperative skeletal muscle mass on the healing time of postoperative pancreatic fistula after pancreaticoduodenectomy.Langenbeck's archives of surgery · 2026Article
- Adjuvant treatment after surgical resection of pancreatic cancer.Surgery today · 2026Review
- Role of preoperative circulating tumor DNA in predicting occult metastases in resectable and borderline resectable pancreatic ductal adenocarcinoma.World journal of gastroenterology · 2025Article
- Survival benefit of adjuvant therapy completion with early initiation for patients with pancreatic ductal adenocarcinoma.Annals of gastroenterological surgery · 2025Article
- Prognostic impact of dose reduced S-1 adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma: a retrospective multicenter study.International journal of clinical oncology · 2025Article
- Pancreatic Fat Accumulation Impacts Postoperative Survival in Patients With Pancreatic Ductal Adenocarcinoma.World journal of surgery · 2025Article
- Adjuvant modified FOLFIRINOX for resected pancreatic adenocarcinoma: clinical insights and genomic features from a large contemporary cohort.Journal of the National Cancer Institute · 2025Article
- Pylorus-preserving pancreatoduodenectomy preserving blood supply for pancreatic cancer with a history of proximal gastrectomy and sigmoidectomy: a case report.Surgical case reports · 2024Article
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Authors and funding
19 authors.
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Abstract
backgroundBased on the Japan Adjuvant Study Group of Pancreatic Cancer-01 results, S-1 adjuvant chemotherapy has been the standard in resected pancreatic ductal adenocarcinoma (PDAC) patients in Japan and elsewhere, initiated within 10 weeks after surgery. To assess the clinical impact of this timing, we conducted a secondary analysis of a nationwide survey by the Japan Pancreas Society.
methodsA total of 3361 patients were divided into two groups: 2681 (79.8%) initiating the therapy within 10 weeks after surgery (standard) and 680 (20.2%) after 10 weeks (delayed). We compared recurrence-free survival (RFS) and overall survival (OS) using the log-rank test and Cox proportional hazards model with conditional landmark analysis between the groups. Results were verified by adjustment with inverse-probability-of-treatment weighting (IPTW) analysis.
resultsThe median timing of S-1 adjuvant chemotherapy initiation was 50 days (interquartile range: 38-66). In the standard group, 5-year RFS and OS rates were 32.3-48.7%, respectively, compared with 25.0-38.7% in the delayed group. Hazard ratios (HRs) and 95% confidence intervals were 0.84 (0.76-0.93) for RFS (p < 0.001) and 0.77 (0.69-0.87) for OS (p < 0.001). The IPTW analysis yielded 5-year RFS rates of 32.1% and 25.3% in the standard versus delayed group, respectively [HR = 0.86 (0.77-0.96), p < 0.001] and 5-year OS rates of 48.3% and 39.8%, respectively [HR = 0.81 (0.71-0.92), p < 0.001].
conclusionsInitiation of S-1 adjuvant chemotherapy in resected PDAC patients within 10 weeks after surgery may offer survival benefit over later initiation.
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