The impact of the timing of adjuvant treatment initiation in patients with upfront resection of pancreatic cancer

Document Type

Article

Publication Date

11-10-2025

Publication Title

Surgical Oncology

Abstract

INTRODUCTION: This study evaluates the association between timing of adjuvant chemotherapy and overall survival in resectable pancreatic ductal adenocarcinoma (PDAC). It also examines whether the adoption of modern chemotherapy regimens in recent years has influenced this relationship, reflecting evolving treatment practices. METHODS: Cases of resectable primary invasive PDAC were identified using the National Cancer Database (NCDB). Overall survival (OS) was visualized using Kaplan Meier survival plots and Cox proportional hazard models. Covariat adjustment and propensity score matched cohort were analyzed. The matched cohort was analyzed with Cox proportional hazard models and logistic models. RESULTS: 31,949 patients were included in the study. 26.4 % received no chemotherapy, 66.4 % received chemotherapy within 12 weeks, and 7.2 % received chemotherapy after 12 weeks. There was significant improvement in mOS. Between 2015 and 2019, there was a significant difference in OS for patients receiving chemotherapy within 12 weeks, compared to >12 weeks. CONCLUSION: While adjuvant chemotherapy in patients with resectable PDAC is associated with improved OS compared to no adjuvant therapy, it is worth considering that those who are well enough to receive chemotherapy inherently have better prognoses. Importantly, the survival association persists regardless of the timing of chemotherapy initiation, suggesting that late administration of adjuvant chemotherapy may still be beneficial in appropriately selected patients.

First Page

1

Last Page

6

PubMed ID

41240676

Volume

64

Rights

/© 2025 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies

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