Neoadjuvant gemcitabine and nab‐paclitaxel for borderline resectable pancreatic cancers: Intention‐to‐treat analysis compared with upfront surgery
Autor: | Naoki Sasahira, Masato Ozaka, Yoshihiro Ono, Takashi Sasaki, Atsushi Oba, Yosuke Inoue, Yu Takahashi, Akio Saiura, Hiromichi Ito, Yoshihiro Mise |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Paclitaxel medicine.medical_treatment Deoxycytidine 03 medical and health sciences 0302 clinical medicine Borderline resectable Albumins Pancreatic cancer Antineoplastic Combined Chemotherapy Protocols medicine Humans Pathological Neoadjuvant therapy Retrospective Studies Intention-to-treat analysis Hepatology business.industry Retrospective cohort study medicine.disease Gemcitabine Neoadjuvant Therapy Intention to Treat Analysis Surgery Pancreatic Neoplasms 030220 oncology & carcinogenesis Cohort 030211 gastroenterology & hepatology business medicine.drug |
Zdroj: | Journal of Hepato-Biliary-Pancreatic Sciences. 28:143-155 |
ISSN: | 1868-6982 1868-6974 |
Popis: | Background/purpose We evaluated efficacy of neoadjuvant therapy with gemcitabine and nab-paclitaxel (GNP-NAT) in borderline resectable pancreatic cancer (BR-PC) patients compared to conventional upfront surgery (UPS). Methods This single-center retrospective study assessed 151 consecutive patients: 96 diagnosed in 2008-2014 underwent UPS (UPS group) and 55 diagnosed in 2015-2017 underwent GNP-NAT (GN group). Patient background, surgical, pathological, and survival outcomes were compared between groups. Results Age, sex, and pretreatment carbohydrate antigen 19-9 were similar between groups. After four courses of NAT-GNP, 46 GN patients (84%) underwent surgery while all UPS patients underwent surgery. Only three GN patients (5%) underwent non-therapeutic procedures, compared to 23 (24%) in the UPS group (P = .004). In the whole cohort, R0-resection was achieved in 40 GN patients (73%) vs 46 UPS patients (48%; P = .004) and the 3-year overall survival was significantly higher in the GN group (median survival time, 31.9 vs 18.1 months, P = .014). In the resection cohort, the R0-resection rate was 93% (GN) vs 63% (UPS; P = .0007). There was no 90-day mortalities in either group. Conclusions Intention-to-treat-based analysis indicated considerable benefits of GNP-NAT in BR-PCs for long-term survival, contributing to improved tumor suppression and patient selection. |
Databáze: | OpenAIRE |
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