Prognostic Relevance of the Timing of Initiating and the Completion of Adjuvant Therapy in Patients with Resected Pancreatic Ductal Adenocarcinoma.
Although the role of adjuvant therapy in patients with pancreatic ductal adenocarcinoma (PDAC) is well established, its optimal timing and duration are still controversial.



The study included 311 patients with PDAC who underwent curative resection followed by adjuvant therapy. We analyzed survival data according to the timing of initiation and completion of adjuvant therapy.



There were no differences in 5-year overall survival (OS) (32.8 vs. 35.4%, p = 0.539) and disease-free survival (DFS) rates (26.2 vs. 23.3%, p = 0.865) between early (≤6 weeks) and late (>6 weeks) initiation of adjuvant therapy. However, the 5-year OS (42.6 vs. 22.2%, p < 0.001) and DFS (29.2 vs. 18.4%, p = 0.042) rates were significantly greater in patients with complete versus incomplete adjuvant therapy. Multivariable analysis revealed that incomplete adjuvant therapy was an independent prognostic factor for decreased OS (p = 0.001; hazard ratio 1.850; 95% confidence interval 1.266-2.702).



The results show that complete adjuvant therapy is a more important prognostic factor than early initiation for improving the survival of patients with resected PDAC.
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.|Department of Surgery, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Woohyung
W
Lee
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea. yoonys@snubh.org.
Yoo-Seok
YS
Yoon
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
Ho-Seong
HS
Han
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Jin Young
JY
Jang
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
Jai Young
JY
Cho
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Woohyun
W
Jung
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Wooil
W
Kwon
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-Si, Gyeonggi-do, 463-707, Republic of Korea.
YoungRok
Y
Choi
Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Sun-Whe
SW
Kim
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D021441:Carcinoma, Pancreatic Ductal / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000628:therapy*; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors