The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection

Daniel J. Kagedan, Ravish S. Raju, Matthew Dixon, Elizabeth Shin, Qing Li, Ning Liu, Maryam Elmi, Abraham El-Sedfy, Lawrence Paszat, Alexander Kiss, Craig C. Earle, Nicole Mittmann, Natalie G. Coburn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Using a retrospective observational cohort approach, the overall survival (OS) following curative-intent resection of pancreatic adenocarcinoma (PC) was defined at the population level according to adjuvant treatment, and predictors of OS were identified. Methods Patients undergoing resection of PC in the province of Ontario between 2005 and 2010 were identified using the provincial cancer registry, and linked to databases that include all treatments received and outcomes experienced in the province. Pathology reports were abstracted for staging and margin status. Patients were identified as having received chemotherapy (CT), chemoradiation therapy (CRT), or no adjuvant treatment (NAT). Kaplan–Meier survival analysis of patients surviving ≥6 months was performed, and predictors of OS identified by log-rank test. Cox multivariable analysis was used to define independent predictors of OS. Results Among the 473 patients undergoing PC resection, the median survival was 17.8 months; for the 397 who survived ≥6 months following surgery, the 5-year OS for the CT, CRT, and NAT groups was 21%, 16%, and 17%, respectively (p = 0.584). Lymph node-negative patients demonstrated improved OS associated with chemotherapy on multivariable analysis (HR = 2.20, 95% CI = 1.25–3.83 for NAT vs. CT). Conclusions Following PC resection, only patients with negative lymph nodes demonstrated improved OS associated with adjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)339-347
Number of pages9
JournalHPB
Volume18
Issue number4
DOIs
StatePublished - Jan 1 2016

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Adenocarcinoma
Survival
Population
Drug Therapy
Therapeutics
Lymph Nodes
Ontario
Adjuvant Chemotherapy
Survival Analysis
Registries
Databases
Pathology
Neoplasms

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kagedan, Daniel J. ; Raju, Ravish S. ; Dixon, Matthew ; Shin, Elizabeth ; Li, Qing ; Liu, Ning ; Elmi, Maryam ; El-Sedfy, Abraham ; Paszat, Lawrence ; Kiss, Alexander ; Earle, Craig C. ; Mittmann, Nicole ; Coburn, Natalie G. / The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection. In: HPB. 2016 ; Vol. 18, No. 4. pp. 339-347.
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abstract = "Background Using a retrospective observational cohort approach, the overall survival (OS) following curative-intent resection of pancreatic adenocarcinoma (PC) was defined at the population level according to adjuvant treatment, and predictors of OS were identified. Methods Patients undergoing resection of PC in the province of Ontario between 2005 and 2010 were identified using the provincial cancer registry, and linked to databases that include all treatments received and outcomes experienced in the province. Pathology reports were abstracted for staging and margin status. Patients were identified as having received chemotherapy (CT), chemoradiation therapy (CRT), or no adjuvant treatment (NAT). Kaplan–Meier survival analysis of patients surviving ≥6 months was performed, and predictors of OS identified by log-rank test. Cox multivariable analysis was used to define independent predictors of OS. Results Among the 473 patients undergoing PC resection, the median survival was 17.8 months; for the 397 who survived ≥6 months following surgery, the 5-year OS for the CT, CRT, and NAT groups was 21{\%}, 16{\%}, and 17{\%}, respectively (p = 0.584). Lymph node-negative patients demonstrated improved OS associated with chemotherapy on multivariable analysis (HR = 2.20, 95{\%} CI = 1.25–3.83 for NAT vs. CT). Conclusions Following PC resection, only patients with negative lymph nodes demonstrated improved OS associated with adjuvant chemotherapy.",
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Kagedan, DJ, Raju, RS, Dixon, M, Shin, E, Li, Q, Liu, N, Elmi, M, El-Sedfy, A, Paszat, L, Kiss, A, Earle, CC, Mittmann, N & Coburn, NG 2016, 'The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection', HPB, vol. 18, no. 4, pp. 339-347. https://doi.org/10.1016/j.hpb.2015.12.005

The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection. / Kagedan, Daniel J.; Raju, Ravish S.; Dixon, Matthew; Shin, Elizabeth; Li, Qing; Liu, Ning; Elmi, Maryam; El-Sedfy, Abraham; Paszat, Lawrence; Kiss, Alexander; Earle, Craig C.; Mittmann, Nicole; Coburn, Natalie G.

In: HPB, Vol. 18, No. 4, 01.01.2016, p. 339-347.

Research output: Contribution to journalArticle

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T1 - The association of adjuvant therapy with survival at the population level following pancreatic adenocarcinoma resection

AU - Kagedan, Daniel J.

AU - Raju, Ravish S.

AU - Dixon, Matthew

AU - Shin, Elizabeth

AU - Li, Qing

AU - Liu, Ning

AU - Elmi, Maryam

AU - El-Sedfy, Abraham

AU - Paszat, Lawrence

AU - Kiss, Alexander

AU - Earle, Craig C.

AU - Mittmann, Nicole

AU - Coburn, Natalie G.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background Using a retrospective observational cohort approach, the overall survival (OS) following curative-intent resection of pancreatic adenocarcinoma (PC) was defined at the population level according to adjuvant treatment, and predictors of OS were identified. Methods Patients undergoing resection of PC in the province of Ontario between 2005 and 2010 were identified using the provincial cancer registry, and linked to databases that include all treatments received and outcomes experienced in the province. Pathology reports were abstracted for staging and margin status. Patients were identified as having received chemotherapy (CT), chemoradiation therapy (CRT), or no adjuvant treatment (NAT). Kaplan–Meier survival analysis of patients surviving ≥6 months was performed, and predictors of OS identified by log-rank test. Cox multivariable analysis was used to define independent predictors of OS. Results Among the 473 patients undergoing PC resection, the median survival was 17.8 months; for the 397 who survived ≥6 months following surgery, the 5-year OS for the CT, CRT, and NAT groups was 21%, 16%, and 17%, respectively (p = 0.584). Lymph node-negative patients demonstrated improved OS associated with chemotherapy on multivariable analysis (HR = 2.20, 95% CI = 1.25–3.83 for NAT vs. CT). Conclusions Following PC resection, only patients with negative lymph nodes demonstrated improved OS associated with adjuvant chemotherapy.

AB - Background Using a retrospective observational cohort approach, the overall survival (OS) following curative-intent resection of pancreatic adenocarcinoma (PC) was defined at the population level according to adjuvant treatment, and predictors of OS were identified. Methods Patients undergoing resection of PC in the province of Ontario between 2005 and 2010 were identified using the provincial cancer registry, and linked to databases that include all treatments received and outcomes experienced in the province. Pathology reports were abstracted for staging and margin status. Patients were identified as having received chemotherapy (CT), chemoradiation therapy (CRT), or no adjuvant treatment (NAT). Kaplan–Meier survival analysis of patients surviving ≥6 months was performed, and predictors of OS identified by log-rank test. Cox multivariable analysis was used to define independent predictors of OS. Results Among the 473 patients undergoing PC resection, the median survival was 17.8 months; for the 397 who survived ≥6 months following surgery, the 5-year OS for the CT, CRT, and NAT groups was 21%, 16%, and 17%, respectively (p = 0.584). Lymph node-negative patients demonstrated improved OS associated with chemotherapy on multivariable analysis (HR = 2.20, 95% CI = 1.25–3.83 for NAT vs. CT). Conclusions Following PC resection, only patients with negative lymph nodes demonstrated improved OS associated with adjuvant chemotherapy.

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