In order to get fresh insights for future directions, researchers for a study sought to examine trends in the treatment approaches for pancreatic ductal adenocarcinoma based on 2,000 consecutive cases in a prospective database since 2012.
Two hundred and ten people were removed from the study’s initial enrollment of 2,000 patients, and 710, 521, and 559 patients received treatment between 2012 and 2015 (group 1), 2016 and 2017 (group 2), and 2018 and 2019 (group 3), respectively. The perioperative results, biological and clinicopathologic characteristics of the patient, and prognostic variables were evaluated.
All patients with pancreatic ductal adenocarcinoma had a median survival of 21.7 months(1-year survival, 75.0%; 2-year survival, 43.7%; 5-year survival, 19.7%). Comparing groups 1 and 2 (median survival time: 23 versus 20.5 and 21.1 months), group 3 showed a superior survival rate. Along with systemic chemotherapy and postoperative adjuvant radiation, the proportion of patients under 65 has progressively grown. The likelihood of early diagnosis (lower CA19-9 and CEA levels, smaller size, and earlier N stage), use of chemotherapy and radiotherapy, early recovery (lesser hospital stay and Clavien-Dindo grade< 3), absence of abdominal pain, younger age, length of operation 3 h, and pathological factors (absence of lymphovascular invasion, peripancreatic fat infiltration and neural invasion, higher differentiation) were associated with patient survival. Tumor biological factors (increased preoperative serum CA19-9 level, tumor size, tumor differentiation, N stage, and presence of lymphovascular invasion and neural invasion), chemotherapy, radiotherapy, abdomen pain, operation period, length of stay, and operation length were all associated with patient survival, according to multivariable analysis for prognosis.
The prognosis following surgical resection for pancreatic ductal adenocarcinoma had steadily improved thanks to systemic treatment, which includes chemotherapy and radiation. Neoadjuvant treatment was helpful to some extent in terms of prognosis improvement. Hospital stays and the incidence of significant complications may be affected by enhanced recovery after surgery (ERAS) strategies and the particular assessment of postoperative pancreatic fistula (POPF) risk. The developments demonstrated that Chinese medical organizations have adopted and are actively utilizing the idea of systemic treatment.
Reference: sciencedirect.com/science/article/abs/pii/S1743919122005635
