Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1663
Peer-review started: March 29, 2023
First decision: April 26, 2023
Revised: May 12, 2023
Accepted: June 12, 2023
Article in press: June 12, 2023
Published online: August 27, 2023
Processing time: 148 Days and 21.6 Hours
Pancreatic adenocarcinoma is currently the fourth leading cause of cancer-related deaths in the United States. In addition to neoadjuvant chemotherapy, neoadjuvant radiotherapy may improve negative margin resection rates. This study seeks to investigate the safety and efficacy of neoadjuvant radiotherapy in patients with pancreatic adenocarcinoma.
By better clarifying the benefits and drawbacks that are associated with neoadjuvant radiotherapy administration in patients with pancreatic adenocarcinoma, practitioners can make informed decisions regarding its use.
The primary objective of the study was to investigate the effect that neoadjuvant radiotherapy has on both intra-operative and 30-d postoperative morbidities in patients with pancreatic adenocarcinoma.
Using 2015-2019 data from the National Surgery Quality Improvement Program data set, we divided pancreatic adenocarcinoma patients into two groups based on neoadjuvant radiotherapy status. Then we performed univariable and multivariable analyses to identify differences in baseline characteristics and outcomes between the two groups.
When compared to patients with pancreatic adenocarcinoma who underwent surgical resection alone, patients who underwent neoadjuvant radiotherapy were more likely to have longer surgeries and higher perioperative blood loss. The neoadjuvant radiotherapy patients were also less likely to have organ space infections and pancreatic fistulae formation.
Neoadjuvant radiotherapy has significant effects on intraoperative and 30-d postoperative morbidity in patients with pancreatic adenocarcinoma. It may make eventual surgical resection of the cancer more complex.
Future research should focus on finding new methods that work to minimize the negative side effects associated with neoadjuvant radiotherapy in patients with pancreatic adenocarcinoma.