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01-11-2021 | Pancreatic Cancer | ASO Author Reflections

ASO Author Reflections: Impact of Neoadjuvant Therapy on Survival After Margin-Positive Resection for Pancreatic Cancer

Authors: Asmita Chopra, MD, Joal D. Beane, MD

Published in: Annals of Surgical Oncology | Issue 12/2021

Excerpt

A positive microscopic margin (R1) after resection of pancreatic ductal adenocarcinoma (PDAC) can occur in up to 80 % of patients and is associated with reduced survival and increased recurrence.1 As such, neoadjuvant therapy (NAT) is increasingly used for patients with PDAC and is the first line of treatment for patients with locally advanced or borderline resectable disease at many centers.2 Use of NAT has been associated with a reduced tumor size on final pathology, lymph node (LN) positivity, and a reduction in margin-positive resections.3‐5 Although other advantages may exist, the impact of NAT on the survival and recurrence pattern in the subset of patients with a positive microscopic surgical margin is unknown. …

Strobel O, Hank T, Hinz U, et al. Pancreatic cancer surgery: the new R-status counts. Ann Surg. 2017;265:565–73. https://doi.org/10.1097/SLA.0000000000001731.CrossRefPubMed

Nagakawa Y, Sahara Y, Hosokawa Y, et al. Clinical impact of neoadjuvant chemotherapy and chemoradiotherapy in borderline resectable pancreatic cancer: analysis of 884 patients at facilities specializing in pancreatic surgery. Ann Surg Oncol. 2019;26:1629–36. https://doi.org/10.1245/s10434-018-07131-8.CrossRefPubMed

Schorn S, Demir IE, Reyes CM, et al. The impact of neoadjuvant therapy on the histopathological features of pancreatic ductal adenocarcinoma: a systematic review and meta-analysis. Cancer Treat Rev. 2017;55:96–106. https://doi.org/10.1016/j.ctrv.2017.03.003.CrossRefPubMed

Sugimoto M, Takahashi N, Farnell MB, et al. Survival benefit of neoadjuvant therapy in patients with non-metastatic pancreatic ductal adenocarcinoma: a propensity-matching and intention-to-treat analysis. J Surg Oncol. 2019;120:976–84. https://doi.org/10.1002/jso.25681.CrossRefPubMed

Lee AJ, Simoneau E, Chiang YJ, et al. Is early-stage pancreatic adenocarcinoma truly early: stage migration on final pathology with surgery-first versus neoadjuvant therapy sequencing. HPB Oxford. 2019;21:1203–10. https://doi.org/10.1016/j.hpb.2019.01.011.CrossRefPubMed

Chopra A, Zenati M, Hogg M, et al. Impact of neoadjuvant therapy on survival following margin positive resection for pancreatic cancer. Ann Surg Oncol. 2021. https://doi.org/10.1245/s10434-021-10175-y.CrossRefPubMed

Title: ASO Author Reflections: Impact of Neoadjuvant Therapy on Survival After Margin-Positive Resection for Pancreatic Cancer
Authors: Asmita Chopra, MD
Joal D. Beane, MD
Publication date: 01-11-2021
Publisher: Springer International Publishing
Keywords: Pancreatic Cancer
Pancreatic Cancer
Published in: Annals of Surgical Oncology / Issue 12/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-10177-w

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ASO Author Reflections: Impact of Neoadjuvant Therapy on Survival After Margin-Positive Resection for Pancreatic Cancer

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