ArticleAnnals of surgical oncology2026
Impact of Different Primary Treatment Strategies on Recurrence-Focused Treatment of Pancreatic Ductal Adenocarcinoma.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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30 authors.
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Abstract
backgroundIncreased application of neoadjuvant therapy (NAT) and adjuvant therapy (AT) could limit treatment options for pancreatic ductal adenocarcinoma (PDAC) recurrence. This study aimed to identify patterns of recurrence-focused treatment and survival following different primary treatment strategies.
methodsAll patients who underwent PDAC resection in the Netherlands (2014-2019) were included. Patients were divided into five groups according to their primary treatment strategy: (1) resection only, (2) gemcitabine-based NAT + resection, (3) FOLFIRINOX-based NAT + resection, (4) resection + gemcitabine-based AT, and (5) resection + FOLFIRINOX-based AT. Differences in recurrence-focused treatment and post-recurrence survival (PRS) were assessed using multivariable logistic and Cox-proportional hazards analyses and were presented as odds ratios (ORs) and hazard ratios (HRs) with corresponding 95% confidence intervals (95% CIs), respectively.
resultsIn total, 1739 patients (median follow-up of 51 [interquartile range 34-64] months) were included, of whom 1272 (73%) had disease recurrence. In these patients, recurrence-focused treatment was administered in 64/124 (52%) after FOLFIRINOX-based NAT compared with 74/410 (18%) with resection only (OR 4.13 [95% CI 3.34-5.12]; P<0.001), 29/70 (41%) with gemcitabine-based NAT (OR 1.61 [95% CI 1.21-2.15]; P<0.001), 239/604 (39%) with gemcitabine-based AT (OR 1.73 [95% CI 1.43-2.09]; P<0.001), and 24/64 (38%) with FOLFIRINOX-based AT (OR 1.44 [95% CI 1.06-1.95]; P=0.02). Recurrence-focused treatment was associated with a median PRS of 11 (95% CI 10-13) months compared with 3 (95% CI 2-3) months in patients with best supportive care (HR 0.31 [95% CI 0.26-0.37]; P<0.001).
conclusionsRecurrence-focused treatment differs between patients with PDAC who received different primary treatment strategies and is associated with improved PRS.
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