Zhang HQ, Li J, Tan CL, Chen YH, Zheng ZJ, Liu XB. Neoadjuvant therapy in resectable pancreatic cancer: A promising curative method to improve prognosis. World J Gastrointest Oncol 2022; 14(10): 1903-1917 [PMID: 36310705 DOI: 10.4251/wjgo.v14.i10.1903]
Corresponding Author of This Article
Chun-Lu Tan, MD, PhD, Associate Professor, Surgeon, Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. chunlutan@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hao-Qi Zhang, Chun-Lu Tan, Yong-Hua Chen, Zhen-Jiang Zheng, Xu-Bao Liu, Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jing Li, Department of Operating Room/West China School of Nursing, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Tan CL and Liu XB designed the study; Zheng ZJ and Chen YH acquired the data; Zhang HQ and Li J analyzed and interpreted the data; Zhang HQ wrote the paper; Tan CL and Liu XB critically revised the manuscript for important intellectual content.
Supported by1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZY2017302 1-3-5; Key Research and Development Projects of Sichuan Province, No. 2019YFS0042; Post-Doctor Research Project, West China Hospital, Sichuan University, No. 2020HXBH168; and Key R&D Project of Science and Technology Department of Sichuan Province, No. 2021YFS0107.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Lu Tan, MD, PhD, Associate Professor, Surgeon, Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. chunlutan@163.com
Received: June 26, 2022 Peer-review started: June 26, 2022 First decision: July 25, 2022 Revised: August 5, 2022 Accepted: September 8, 2022 Article in press: September 8, 2022 Published online: October 15, 2022 Processing time: 110 Days and 6.3 Hours
Abstract
Currently, 15 randomized controlled trials (RCTs) have been designed to investigate whether neoadjuvant therapy (NAT) benefits patients with resectable pancreatic adenocarcinoma (R-PA) compared to surgery alone. Five of them have acquired results so far; however, corresponding conclusions have not been obtained. We speculated that the reason for this phenomenon could be that some prognostic factors had proven to be adverse through upfront surgery curative patterns, but some of them were not regarded as independent baseline characteristics, which is important to obtaining comparability between the NAT and upfront surgery groups. This fact could cause bias and lead to the difference in the outcomes of RCTs. In this review, we collate data about risk factors (such as tumor size, resection margin, and lymph node status) influencing the prognoses of patients with R-PA from five RCTs and discuss the possible reasons for the varying outcomes.
Core Tip: In this review, we collate data about risk factors influencing the prognoses of patients with resectable pancreatic cancer from five randomized controlled trials (RCTs) and discuss the possible reasons for the varying outcomes. By comparing the overall survival of two RCTs, we speculated that neoadjuvant therapy might actually benefit patients with low-risk factors for long-term survival. Moreover, we address some suggestions for the RCTs in the future.
