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Neoadjuvant gemcitabine and nab‐paclitaxel for borderline resectable pancreatic cancers: Intention‐to‐treat analysis compared with upfront surgery
- Source :
- Journal of Hepato-Biliary-Pancreatic Sciences. 28:143-155
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 18686982 and 18686974
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Hepato-Biliary-Pancreatic Sciences
- Accession number :
- edsair.doi.dedup.....fc6e63b35a09b9db61ca8dacc42c3978