SynthesisBJS open2025
Neoadjuvant treatment versus upfront surgery in borderline resectable and resectable pancreatic ductal adenocarcinoma: meta-analysis.
Synthesis in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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.
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.
Who cites it
10 citing papers in PubMed.
- The Progress of Pancreatectomy for Pancreatic Cancer Treatment-Lessons Learned and Future Challenges.Cancers · 2026Review
- Review
- Upfront Chemotherapy Versus Immediate Surgery for Operable Pancreatic Cancer: An Umbrella Review of Meta-Analyses.Cancers · 2026Review
- Surgical Perspectives on Neoadjuvant Therapy in Borderline Resectable and Locally Advanced Pancreatic Cancer.Cancers · 2026Review
- Conversion and resection rates in borderline resectable and locally advanced pancreatic cancer following neoadjuvant therapy: a retrospective multicenter cohort study.Frontiers in oncology · 2026Article
- Surgical decision-making in borderline resectable pancreatic cancer in the era of neoadjuvant therapy: from response assessment to individualized operative strategy.Frontiers in surgery · 2026Review
- Pancreatic Neuroendocrine Tumor with Acinar Pattern Mimicking Pancreatic Ductal Adenocarcinoma: A Case Report.Surgical case reports · 2026Article
- Surgical and survival outcomes of neoadjuvant IMRT-based chemoradiotherapy versus upfront surgery in borderline resectable pancreatic cancer: a retrospective cohort study.Frontiers in oncology · 2026Article
- Pancreatic Club Perspectives on Surgical Approach, Post-Resection Follow-Up, and Role of Endoscopic Ablation on Pancreatic Cystic Neoplasms.GE Portuguese journal of gastroenterology · 2025Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreatic cancer prognosis remains poor despite advances in adjuvant treatment. Neoadjuvant treatment may improve survival and disease-free survival. This meta-analysis evaluates the outcomes for patients with borderline-resectable (borderline-resectable pancreatic cancer) or resectable disease (resectable pancreatic cancer) in randomized trials of neoadjuvant therapy versus upfront surgery.
methodsThe review was performed according to PRISMA guidance. Articles were included from the start of the database until 1 May 2024. The primary outcome was overall survival. Secondary outcomes were progression-free survival, resection rate, R0 rate, N0 rate, vascular resection rate, surgical complications, significant adverse events and rates of adjuvant therapy. Data was collected from study manuscripts or through individual patient-level data extraction. Meta-analysis was performed using a random-effects model with subgroup comparisons for resectability status (resectable pancreatic cancer versus borderline-resectable pancreatic cancer) and treatment modality (chemotherapy versus chemoradiotherapy).
resultsNine trials were included representing 1194 patients. Four trials recruited borderline-resectable pancreatic cancer, four resectable pancreatic cancer and one both. Four trials reported chemotherapy, four chemoradiotherapy and one both treatments. Neoadjuvant treatment improved overall survival (HR 0.73, 95% c.i. 0.55 to 0.98; P = 0.001) and progression-free survival (HR 0.80, 95% c.i. 0.65 to 0.99; P = 0.041). Subgroup analysis demonstrated neoadjuvant treatment improved overall survival for borderline-resectable pancreatic cancer (HR 0.60, 95% c.i. 0.38 to 0.96) but not resectable pancreatic cancer (HR 0.90, 95% c.i. 0.63 to 1.28). The overall resection rate was lower in neoadjuvant treatment (72.6% versus 80.6%, RR 0.94, 95% c.i. 0.89 to 0.99; P = 0.020). R0 rate (43.8% versus 23.0%, RR 1.35, 95% c.i. 1.16 to 1.57; P = 0.002) and N0 rate (30.9% versus 15.0%, RR 2.03, 95% c.i. 1.50 to 2.74; P = 0.001) was improved in neoadjuvant treatment. Significant adverse events occurred more frequently in neoadjuvant treatment (56.1% versus 27.0%, RR 1.92, 95% c.i. 1.28 to 1.89; P = 0.007).
conclusionNeoadjuvant treatment significantly improves survival in borderline-resectable pancreatic cancer but not resectable pancreatic cancer. It should be regarded as standard of care for these patients. Further work is needed to identify the optimum neoadjuvant regimen and a possible role in the treatment of resectable pancreatic cancer.
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