Evidence map›Paper›PMID 40439878›Full record

ArticleAnnals of surgical oncology2025

Association Between Adjuvant Therapy and Survival in Resected Pancreatic Ductal Adenocarcinoma After Different Types and Durations of Neoadjuvant Therapy.

Paul C M Andel, Brady A Campbell, Joseph R Habib, I Quintus Molenaar, Kelly J Lafaro, William R Burns, Lois A Daamen, John L Cameron, Christopher L Wolfgang, Richard A Burkhart and 2 more

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

12 authors.

Paul C M AndelDepartment of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA.
Brady A CampbellDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Joseph R HabibDepartment of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA.
I Quintus MolenaarDepartment of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein, Utrecht, The Netherlands.
Kelly J LafaroDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
William R BurnsDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lois A DaamenDepartment of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein, Utrecht, The Netherlands.
John L CameronDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher L WolfgangDepartment of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA.
Richard A BurkhartDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jin HeDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ammar A JavedDepartment of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA. Ammar.Javed@nyulangone.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) is increasingly being used. The aim of this study was to evaluate the association between type, duration, and sequencing of adjuvant therapy (AT) after NAT and overall survival (OS) in patients with resected PDAC.

methodsPatients receiving NAT and resection for PDAC (2010-2019) at two high-volume pancreatic surgery centers were included and stratified into groups on the basis of NAT regimen: gemcitabine-based NAT, 5-fluorouracil (5FU)-based NAT, or switched NAT regimen. The maximally selected rank statistic was used to determine the optimal NAT duration. Univariate and multivariable Cox proportional hazards models were used to assess the association between NAT regimen and OS, and between AT and OS.

resultsOf 651 patients, 200 (30.7%) received gemcitabine-based NAT, 362 (56%) received 5FU-based NAT, and 89 (13.7%) switched NAT regimen. Median OS in patients receiving gemcitabine-based NAT was 19 months (95% confidence interval (CI) 17-25 months), compared with 26 months (95% CI 24-31 months) in patients receiving 5FU-based NAT (hazard ratio (HR) 0.81, 95% CI 0.66-0.99, p = 0.04) and 21 months (95% CI 16-26 months) in patients who switched NAT regimen (HR 0.98, 95% CI 0.73-1.29, p = 0.86). Optimal NAT duration was 3.6 months in the complete cohort. Receiving AT was associated with improved survival (HR 0.61, 95% CI 0.43-0.86, p < 0.001), but its association was reduced after a NAT duration of ≥5 months (adjuvant chemotherapy × NAT duration ≥ 5 months: HR 1.50, 95% CI 1.00-2.24, p = 0.048).

conclusionsPatients receiving 5FU-based NAT showed improved survival compared with patients receiving gemcitabine-based NAT before surgery for PDAC. Adjuvant therapy improved survival, particularly in patients with shorter NAT duration.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsAgedChemotherapy, AdjuvantDeoxycytidineFemaleFluorouracilFollow-Up StudiesGemcitabineHumansMaleMiddle AgedPrognosisDeoxycytidineFluorouracilGemcitabine

Identifiers

PMID40439878
PMCPMC12317898

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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.