Evidence map›Paper›PMID 42236648›Full record

ArticleAnnals of surgical oncology2026

Benefit of Adjuvant Therapy After Neoadjuvant Therapy and Resection for Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis.

Michael C Frey, Victor Lopez-Lopez, Alessia Benz, Sarvar Abdurakhmonov, Haleh Amirian, Jashodeep Datta, So Heun Lee, Changhoon Yoo, Ning Pu, Chunmeng Zhang and 5 more

Abstract read
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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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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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

2 citing papers in PubMed.

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4 · The record

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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

15 authors.

Michael C FreyDepartment of Surgery and Transplantation, University Hospital Zürich, Zurich, Switzerland.
Victor Lopez-LopezDepartment of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, Murcia, Spain.
Alessia BenzDepartment of Surgery and Transplantation, University Hospital Zürich, Zurich, Switzerland.
Sarvar AbdurakhmonovDepartment of Surgery, Faculty of Medicine, Karshi State University, Qarshi, Uzbekistan.
Haleh AmirianDepartment of Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
Jashodeep DattaDepartment of Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
So Heun LeeDepartment of Oncology, ASAN Medical Center, University of Ulsan College of Medicine, Ulsan, South Korea.
Changhoon YooDepartment of Oncology, ASAN Medical Center, University of Ulsan College of Medicine, Ulsan, South Korea.
Ning PuDepartment of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Chunmeng ZhangDivision of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Bradley N ReamesDivision of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Ralph FritschDepartment of Oncology, University Hospital Zürich, Zurich, Switzerland.
Henrik PetrowskyDepartment of Surgery and Transplantation, University Hospital Zürich, Zurich, Switzerland.
José OberholzerDepartment of Surgery and Transplantation, University Hospital Zürich, Zurich, Switzerland.
Dilmurodjon EshmuminovDepartment of Surgery and Transplantation, University Hospital Zürich, Zurich, Switzerland. dilmurodjon.eshmuminov@usz.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn recent years, neoadjuvant therapy (NAT) has received growing interest and is now the standard of care for borderline resectable (BR) pancreatic cancer (PC) and locally advanced (LA) PC. Despite the proven benefits of both NAT and adjuvant therapy (AT), a critical question remains: whether patients undergoing pancreatectomy after NAT still benefit from additional adjuvant chemotherapy. In this systematic review and meta-analysis, we aimed to answer that question and explore potential subgroups and regimens that increase or decrease a potential survival advantage.

methodsA comprehensive systematic literature search was performed. The primary outcome measure was overall survival (OS), expressed as hazard ratios (HRs). HRs and their corresponding 95% confidence intervals (CIs) were collected to compare survival between patients who did and did not receive AT. The ROBINS-I-tool was used to assess the risk of bias for all included non-randomized studies.

resultsOverall, 29,119 patients from 30 articles with PC who underwent NAT and surgical resection with reporting of AT were included. Patients who received AT after NAT and surgical resection demonstrated a significantly longer OS, with a pooled HR of 0.85 (95% CI 0.8-0.89; p<0.0001). Patients with N0 disease gained benefit from AT, with an HR of 0.87 (95% CI 0.80-0.94; p=0.0008). AT after NAT in patients with N+ disease demonstrated an even clearer improved OS, with an HR of 0.74 (95% CI 0.65-0.85; p<0.0001).

conclusionAT after NAT and surgical resection may improve OS, especially for patients with a positive nodal status, but, importantly, also for patients with a negative nodal status. Future studies should focus on detailed reporting of chemotherapy regimens and resectability criteria.

Indexed as

Adjuvant therapyChemotherapyNeoadjuvant therapyPancreatic cancerPancreatic surgery

Identifiers

PMID42236648

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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.