Evidence map›Paper›PMID 39801373›Full record

ArticleJournal of surgical oncology2025

Sequence of Chemotherapy May Not Impact Survival After Resection of Pancreatic Tail Adenocarcinoma.

Chase J Wehrle, Jenny Chang, Abby Gross, Breanna Perlmutter, Robert Naples, Katherine Stackhouse, Toms Augustin, Daniel Joyce, Robert Simon, Andrea Schlegel and 3 more

Abstract read
In one paragraph

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Chase J WehrleDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.ORCID http://orcid.org/0000-0002-9275-4744
Jenny ChangDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Abby GrossDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Breanna PerlmutterDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.ORCID http://orcid.org/0000-0002-6546-3909
Robert NaplesDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Katherine StackhouseDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Toms AugustinDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Daniel JoyceDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Robert SimonDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Andrea SchlegelDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
R Matthew WalshDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Samer A NaffoujeDepartment of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Alessandro ParenteInstitute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0001-5506-224X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPancreatic ductal adenocarcinoma (PDAC) of the body/tail is notably different than PDAC in the head of the pancreas. Surgery plus chemotherapy is known to improve outcomes for all PDAC. The sequence of this therapy is well studied in head cancers yet has never been evaluated systematically in relation to distal pancreatectomy (DP).

methodsPatients receiving DP for PDAC and who received chemotherapy were included. Patients were compared receiving neoadjuvant systemic therapy (NAST) only, adjuvant (AST) only, both NAST + AST, and who received total neoadjuvant therapy (TNT), defined as > 24 weeks NAST before DP. PSM was performed 1:1 between AST and each other group creating quadruplets of patients for analysis. Matching factors were determined by multivariate cox-regression analysis of factors independently affecting survival. Survival was considered from diagnosis and from surgery to account for potential biases.

resultsIn total, 4677 patients were selected with 400 (8.6%) receiving TNT, 536 (11.5%) NAST, 3235 (69.2%) AST, and 506 (10.8%) NAST + AST. A total of 341 quadruplets were selected after PSM. There were no differences in comorbidities, T/N-stage, retrieved or positive lymph nodes, and margin status after matching. Kaplan-Meier analysis showed no difference in median OS between the matched treatment groups (33.71 ± 2.07 vs. 35.22 ± 1.62 vs. 32.53 ± 3.31 vs. 37.88 ± 1.90, respectively; log-rank p = 0.464). Five-year OS was not different between the groups (21% vs. 18% vs. 20% vs. 25%, respectively; p = 0.501).

conclusionThe sequence of chemotherapy and surgery did not impact survival in distal PDAC. Providers should tailor an individualized approach designed to maximize the chance of completing both treatments.

Indexed as

AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsAgedChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesSurvival Rate

Identifiers

PMID39801373
PMCPMC12186010

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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.