Evidence map›Paper›PMID 41697473›Full record

ArticleAnnals of surgical oncology2026

Optimal Timing of Adjuvant Therapy in Patients with Poorly Differentiated Pancreatic Adenocarcinoma.

Mihir M Shah, Parit T Mavani, Subir Goyal, David A Kooby, Juan M Sarmiento, Jordan A Kempker, Thomas M Fishbein, Timothy J Kennedy, Theresa W Gillespie

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

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.

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

9 authors.

Mihir M Shah *Division of Surgical Oncology, Department of Surgery, MedStar Georgetown Lombardi Cancer Center, Washington, DC, USA. Mihir.m.shah@medstar.net.ORCID http://orcid.org/0000-0002-4665-5534
Parit T Mavani *Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Subir GoyalBiostatistics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
David A KoobyDivision of Surgical Oncology, Department of Surgery, MedStar Georgetown Lombardi Cancer Center, Washington, DC, USA.
Juan M SarmientoDivision of Surgical Oncology, Department of Surgery, MedStar Georgetown Lombardi Cancer Center, Washington, DC, USA.
Jordan A KempkerDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Thomas M FishbeinDepartment of Surgery, Georgetown University and MedStar Health, Washington, DC, USA.
Timothy J KennedyDivision of Surgical Oncology, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA.
Theresa W GillespieDepartment of Surgery and Department of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.

Funding

Emory Clinical Oncology Career Development Award K12 ProgramK12CA237806 · NCI · EMORY UNIVERSITY · PI DHODAPKAR, KAVITA MADHAV, RAMALINGAM, SURESH S · 2019 to 2023
$2.2M
Georgia Clinical and Translational Science Alliance ULI TR002378National Institute of Health/National Cancer Institute P30CA138292NCI NIH HHS K12 CA237806
6 · The paper itself

Abstract

backgroundMultimodal therapy, combining chemotherapy and surgical resection, is the standard of care for patients with resectable pancreatic ductal adenocarcinoma (PDAC). Patients with poorly differentiated PDAC have suboptimal overall survival (OS), partly owing to the limited understanding of optimal timing for return to intended oncologic therapy (RIOT) after upfront surgery. We aim to evaluate patients with poorly differentiated PDAC who undergo upfront surgical resection and assess how the timing of receipt of adjuvant chemotherapy is associated with OS. PATIENTS AND

methodsUsing the National Cancer Database, we identified patients with poorly differentiated nonmetastatic PDAC who received upfront surgical resection followed by adjuvant chemotherapy (2007-2016). Adjusted Cox proportional hazard models evaluated OS on the basis of RIOT timing. Logistic regression was used to identify factors associated with RIOT.

resultsOf 2737 included patients, 66.1% (n = 1810) did RIOT within 9 weeks and 33.9% (n = 927) after 9 weeks. The median age of the study cohort was 62 years; 52% (n = 1583) were male and 87.1% (n = 2657) were white. Adjusted multivariable analysis noted that patients who did RIOT within 9 weeks were associated with improved OS compared with patients who did RIOT after 9 weeks (adjusted hazard ratio [aHR] 0.90, 95% confidence interval [CI] 0.82-0.99, p = 0.03). Treatment at academic facilities was associated with lower odds of RIOT within 9 weeks compared with treatment at non-academic facilities (adjusted odds ratio [aOR] 0.83, 95% CI 0.70-0.98, p = 0.03).

conclusionsPatients with poorly differentiated pancreatic ductal adenocarcinoma may benefit from adjuvant therapy within 9 weeks after surgical resection. Opportunities may exist in academic facilities to facilitate adjuvant therapy within 9 weeks of surgical resection.

Indexed as

AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalCell DifferentiationPancreatectomyPancreatic NeoplasmsTime-to-TreatmentAgedChemotherapy, AdjuvantCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisNational Cancer DatabaseOverall survivalPancreatic ductal adenocarcinomaPoorly differentiatedReturn to intended oncologic therapy

Identifiers

PMID41697473
PMCPMC13157228

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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.