Evidence map›Paper›PMID 38789615›Full record

ArticleAnnals of surgical oncology2024

Adjuvant Chemotherapy With or Without Radiotherapy for Resected Pancreatic Cancer After Multiagent Neoadjuvant Chemotherapy.

Oskar Franklin, Toshitaka Sugawara, Richard Blake Ross, Salvador Rodriguez Franco, Kathryn Colborn, Sana Karam, Richard D Schulick, Marco Del Chiaro

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Pancreatic cancer in 2025: Have we found a solution?World journal of gastroenterology · 2025
    Review
  3. Review
  4. 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

8 authors.

Oskar FranklinDivision of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Toshitaka SugawaraDivision of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Richard Blake RossDepartment of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
Salvador Rodriguez FrancoDivision of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Kathryn ColbornDepartment of Biostatistics and Informatics, University of Colorado School of Medicine, Aurora, CO, USA.
Sana KaramDepartment of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
Richard D SchulickDepartment of Surgery, University of Colorado, Aurora, CO, USA.
Marco Del ChiaroDivision of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. marco.delchiaro@cuanschutz.edu.

Funding

Tackling Treg mediated resistance to radiation and anti-PDL1 in HNSCCsR01DE028529 · NIDCR · WASHINGTON UNIVERSITY · PI SANA D KARAM · 2019 to 2026
$3.7M
Role of EphB4-ephrin-B2 interaction in regulating crosstalk between cancer cell and vascular tumor microenvironment in head and neck cancerR01DE028282 · NIDCR · UNIVERSITY OF COLORADO DENVER · PI KARAM, SANA D · 2019 to 2023
$2.4M
NIDCR NIH HHS 1P50CA261605-01NIDCR NIH HHS R01 DE028282-01NIDCR NIH HHS R01 DE028529-01Region Västerbotten RV 967602Royal Swedish Academy of Sciences LM2021-0010Royal Swedish Academy of Sciences LM2023-0012Svenska Läkaresällskapet SLS-934237
6 · The paper itself

Abstract

backgroundAdjuvant therapy is associated with improved pancreatic cancer survival after neoadjuvant chemotherapy and surgery. However, whether adjuvant treatment should include radiotherapy is unclear in this setting.

methodsThis study queried the National Cancer Database for pancreatic adenocarcinoma patients who underwent curative resection after multiagent neoadjuvant chemotherapy between 2010 and 2019 and received adjuvant treatment. Adjuvant chemotherapy plus radiotherapy (external beam, 45-50.4 gray) was compared with adjuvant chemotherapy alone. Uni- and multivariable Cox regression was used to assess survival associations. Analyses were repeated in a propensity score-matched subgroup.

resultsOf 1983 patients who received adjuvant treatment after multiagent neoadjuvant chemotherapy and resection, 1502 (75.7%) received adjuvant chemotherapy alone and 481 (24.3%) received concomitant adjuvant radiotherapy (chemoradiotherapy). The patients treated with adjuvant chemoradiotherapy were younger, were treated at non-academic facilities more often, and had higher rates of lymph node metastasis (ypN1-2), positive resection margins (R1), and lymphovascular invasion (LVI+). The median survival was shorter for the chemoradiotherapy-treated patients according to the unadjusted analysis (26.8 vs 33.2 months; p = 0.0017). After adjustment for confounders, chemoradiotherapy was associated with better outcomes in the multivariable model (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.61-0.93; p = 0.008). The association between chemoradiotherapy and improved outcomes was stronger for the patients with grade III tumors (HR, 0.53; 95% CI, 0.37-0.74) or LVI+ tumors (HR, 0.58; 95% CI, 0.44-0.75). In a subgroup of 396 propensity-matched patients, chemoradiotherapy was associated with a survival benefit only for the patients with LVI+ or grade III tumors.

conclusionAfter multiagent neoadjuvant chemotherapy and resection for pancreatic cancer, additional adjuvant chemoradiotherapy versus adjuvant chemotherapy alone is associated with improved survival for patients with LVI+ or grade III tumors.

Indexed as

AdenocarcinomaNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRadiotherapy, AdjuvantRetrospective StudiesSurvival RateAdjuvant therapyChemotherapyNeoadjuvant therapyPancreatic cancerRadiotherapySurgery

Identifiers

PMID38789615

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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.