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dc.contributor.authorWijetunga, AR
dc.contributor.authorChua, TC
dc.contributor.authorNahm, CB
dc.contributor.authorPavlakis, N
dc.contributor.authorClarke, S
dc.contributor.authorChan, DL
dc.contributor.authorDiakos, C
dc.contributor.authorMaloney, S
dc.contributor.authorAshrafi-Zadeh, A
dc.contributor.authorKneebone, A
dc.contributor.authorHruby, G
dc.contributor.authorJamieson, NB
dc.contributor.authorGill, A
dc.contributor.authorMittal, A
dc.contributor.authorSamra, JS
dc.date.accessioned2021-05-17T01:41:18Z
dc.date.available2021-05-17T01:41:18Z
dc.date.issued2021
dc.identifier.issn0748-7983en_US
dc.identifier.doi10.1016/j.ejso.2021.04.005en_US
dc.identifier.urihttp://hdl.handle.net/10072/404422
dc.description.abstractBackground: Pancreatic cancer is the 8th commonest cancer and the 5th commonest cause of cancer-related death in Australia, with a 9% average 5-year survival. This study aims to investigate the effects of neoadjuvant treatment on overall survival (OS) and recurrence-free survival (RFS) in borderline resectable (BRPC) and locally advanced (LAPC) pancreatic adenocarcinoma followed by curative resection. Materials and methods: Prospectively-collected demographic, medical, surgical and pathological data of patients with BRPC and LAPC treated with both neoadjuvant therapy (NAT) and surgery at a single tertiary referral centre in Australia were reviewed and analysed. Results: Between 2012 and 2018, 60 patients, 34 with BRPC and 26 with LAPC, were treated with NAT followed by curative resection. The commonest neoadjuvant chemotherapy regimens were Gemcitabine + Abraxane (51.7%) and FOLFIRINOX (35.0%), with 48.3% of patients additionally receiving neoadjuvant radiotherapy. Median RFS was 30 months and median OS was 35 months. On multivariable analysis, inferior OS was predicted by enlarged loco-regional lymph nodes on initial computed tomography (p = 0.032), larger tumour size post-NAT (p = 0.006) and Common Terminology Criteria for Adverse Events post-NAT toxicity greater than grade 2 (p = 0.015). LAPC patients received more neoadjuvant chemotherapy (p = 0.008) and radiotherapy (p = 0.021) than BRPC and achieved a superior pathological response (p = 0.010). Conclusion: Patients who respond to NAT likely have a favourable disease biology and will progress well following resection. It is these patients who should be selected for more aggressive upfront management, and those with resistant disease should be spared from high-risk surgery.en_US
dc.description.peerreviewedYesen_US
dc.languageenen_US
dc.publisherElsevier BVen_US
dc.relation.ispartofjournalEuropean Journal of Surgical Oncologyen_US
dc.subject.fieldofresearchOncology and Carcinogenesisen_US
dc.subject.fieldofresearchcode1112en_US
dc.titleSurvival in borderline resectable and locally advanced pancreatic cancer is determined by the duration and response of neoadjuvant therapy: Survival in advanced pancreatic canceren_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationWijetunga, AR; Chua, TC; Nahm, CB; Pavlakis, N; Clarke, S; Chan, DL; Diakos, C; Maloney, S; Ashrafi-Zadeh, A; Kneebone, A; Hruby, G; Jamieson, NB; Gill, A; Mittal, A; Samra, JS, Survival in borderline resectable and locally advanced pancreatic cancer is determined by the duration and response of neoadjuvant therapy: Survival in advanced pancreatic cancer, European Journal of Surgical Oncology, 2021en_US
dc.date.updated2021-05-17T00:56:14Z
gro.description.notepublicThis publication is entered as an advnaced online version in Griffith Research Online.en_US
gro.hasfulltextNo Full Text
gro.griffith.authorChua, Terence


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