Abstract
Abstract Background The clinical impact of giving adjuvant chemotherapy after resection for adenocarcinoma arising from intraductal papillary mucinous neoplasia (IPMN) is unclear. The present study aims to identify factors related to receipt of adjuvant chemotherapy, the type and its impact on recurrence, site specific recurrence and survival in a large international cohort of patients. Method Patients undergoing pancreatic resection for adenocarcinoma arising from IPMN between 2010-2020 at 18 pancreatic centres were identified. Propensity score matching (PSM) and survival analyses were performed to identify the impact of adjuvant chemotherapy on recurrence and survival. Results A total of 459 patients underwent pancreatic resection and 275 patients (59.9%) received adjuvant chemotherapy (Gemcitabine,51.3%; Gemcitabine-capecitabine,21.8%; Folfirinox,8.0%; and other,18.9%). In multivariate analysis, poor differentiation (30.2%vs.19.0%; p=0.007) was associated with adjuvant chemotherapy use. Adjuvant chemotherapy was not associated with all, locoregional, systemic or site-specific recurrence compared to no adjuvant chemotherapy on Kaplan-Meier analysis (median time to recurrence 26 versus 50 months; p=0.14), multivariate analysis (HR 0.79, p=0.175), and on propensity score matching (HR 0.76, p=0.111). No particular subgroup had lower rates of recurrence with adjuvant chemotherapy. No particular chemotherapy regime resulted in lower recurrence rates or longer survival. The overall or disease-free survival rates were not significantly different in multivariate analysis. Conclusion Based on the contemporary data, adjuvant chemotherapy after pancreatic resection for adenocarcinoma arising from IPMN does not appear to impact on recurrence rates, recurrence patterns and long term survival. However, data on the most potent chemotherapy (Folfirinox) is limited and warrants further studies
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
