Analysis of Perioperative Chemotherapy in Resected Pancreatic Cancer: Identifying the Number and Sequence of Chemotherapy Cycles Needed to Optimize Survival
| Autor: | Ahmad Hamad, Amer H. Zureikat, Nathan Bahary, Mazen S. Zenati, Jennifer Steve, Kenneth K. Lee, Irene Epelboym, Melissa E. Hogg, Herbert J. Zeh |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
Male medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Deoxycytidine 03 medical and health sciences 0302 clinical medicine Pancreatic cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasm Invasiveness Perioperative Period Survival rate Neoadjuvant therapy Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Chemotherapy business.industry Proportional hazards model Hazard ratio Margins of Excision Perioperative Middle Aged medicine.disease Gemcitabine Confidence interval Neoadjuvant Therapy Tumor Burden Pancreatic Neoplasms Survival Rate Chemotherapy Adjuvant 030220 oncology & carcinogenesis Lymph Node Excision 030211 gastroenterology & hepatology Surgery Female Fluorouracil business |
| Zdroj: | Annals of surgical oncology. 24(9) |
| ISSN: | 1534-4681 |
| Popis: | Receipt of 6 cycles of adjuvant chemotherapy (AC) is standard of care in pancreatic cancer (PC). Neoadjuvant chemotherapy (NAC) is increasingly utilized; however, optimal number of cycles needed alone or in combination with AC remains unknown. We sought to determine the optimal number and sequence of perioperative chemotherapy cycles in PC. Single institutional review of all resected PCs from 2008 to 2015. The impact of cumulative number of chemotherapy cycles received (0, 1–5, and ≥6 cycles) and their sequence (NAC, AC, or NAC + AC) on overall survival was evaluated Cox-proportional hazard modeling, using 6 cycles of AC as reference. A total of 522 patients were analyzed. Based on sample size distribution, four combinations were evaluated: 0 cycles = 12.1%, 1–5 cycles of combined NAC + AC = 29%, 6 cycles of AC = 25%, and ≥6 cycles of combined NAC + AC = 34%, with corresponding survival. 13.1, 18.5, 37, and 36.8 months. On MVA (P |
| Databáze: | OpenAIRE |
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