Evidence map›Paper›PMID 40858953›Full record

ArticleAnnals of surgical oncology2025

Evaluating Tumor Regression and Survival Outcomes in Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment according to CAP Grading System: Clinical Usefulness and Limitations.

Go-Won Choi, Younsoo Seo, Inhyuck Lee, Yoon Soo Chae, Won-Gun Yun, Youngmin Han, Hye-Sol Jung, Young Jae Cho, Wooil Kwon, Joon Seong Park and 1 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. An erratum has been issued. 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

5 · Who and what money

Authors and funding

11 authors.

Go-Won ChoiDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Younsoo SeoDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Inhyuck LeeDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yoon Soo ChaeDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Won-Gun YunDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Youngmin HanDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Hye-Sol JungDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Young Jae ChoDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Wooil KwonDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Joon Seong ParkDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jin-Young JangDepartment of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. jangjy4@snu.ac.kr.ORCID http://orcid.org/0000-0003-3312-0503

Funding

National Research Foundation of Korea 2022R1A2C2011122
6 · The paper itself

Abstract

backgroundNeoadjuvant treatment (NAT) is increasingly employed for pancreatic ductal adenocarcinoma (PDAC), necessitating reliable methods to assess tumor response. The College of American Pathologists (CAP) grading system is widely used to predict chemo-responsiveness and survival, but consensus on the most effective grading system and treatment regimen remains elusive. PATIENTS AND

methodsThis retrospective study included 462 patients with PDAC who underwent resection after NAT between 2009 and 2023. Survival outcomes were analyzed on the basis of CAP grades, and factors influencing favorable tumor responses were identified.

resultsPatients with CAP grades 0 and 1 showed significantly better overall survival (OS) and disease-free survival (DFS) than those with CAP grades 2 and 3. Key factors associated with improved outcomes included the 5-fluorouracil, irrinotecan, leucovorin, and oxaliplatin (FOLFIRINOX) regimen, stereotactic ablative body radiotherapy (SABR), and adjuvant chemotherapy. Despite achieving a pathological complete response, younger patients and those with pre-NAT suspected metastases were more prone to recurrence.

conclusionsCAP grade is a strong prognostic tool for PDAC after NAT. Survival outcomes are enhanced by FOLFIRINOX, SABR, and adjuvant chemotherapy. Ongoing adjuvant therapy and monitoring are crucial for younger patients or those with pre-NAT metastasis. Further studies should refine tumor grading systems and explore objective post-NAT evaluation methods.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalNeoadjuvant TherapyPancreatic NeoplasmsAdultAgedChemotherapy, AdjuvantFemaleFluorouracilFollow-Up StudiesHumansIrinotecanLeucovorinMaleMiddle AgedNeoplasm GradingFluorouracilfolfirinoxIrinotecanLeucovorinOxaliplatinCAP gradeNeoadjuvant treatmentPancreatic cancerPathologic complete responseTumor regression grading

Identifiers

PMID40858953
PMCPMC12589204

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