Early-onset Pancreatic Cancer Patients Benefit More From Neoadjuvant Chemotherapy And Surgery

Background and objectives

The incidence of early-onset pancreatic crab (EOPC) is rising, yet optimal curen strategies stay unclear. While adjuvant chemotherapy (ACT) has shown endurance benefits successful pancreatic ductal adenocarcinoma, its circumstantial domiciled successful EOPC patients pursuing neoadjuvant chemotherapy (NACT) and room remains underexplored. This study aimed to measure nan objective use of ACT successful EOPC patients aft NACT.

Methods

This retrospective cohort study analyzed pancreatic ductal adenocarcinoma patients from nan SEER database (2006–2019) who received NACT followed by curative resection. Propensity people matching (1:1) was utilized to equilibrium covariates specified arsenic tumor, lymph node, metastasis stage, chemotherapy, and radiotherapy. Overall endurance (OS) and cancer-specific endurance (CSS) were compared betwixt patients pinch EOPC (<50 years) and average-onset pancreatic crab (AOPC, ≥50 years). Multivariate Cox regression study was performed to place prognostic factors.

Results

After propensity people matching (124 EOPC vs. 124 AOPC), EOPC patients had importantly longer median OS (41.0 vs. 29.0 months, P = 0.042) and CSS (48.0 vs. 30.0 months, P = 0.016). ACT was an independent prognostic facet for EOPC (OS: hazard ratio = 0.495, 95% assurance interval 0.271–0.903, P = 0.022; CSS: hazard ratio = 0.419, 95% assurance interval 0.219–0.803, P = 0.009), but not for AOPC (P > 0.05). Subgroup study revealed that EOPC patients pinch tumor, lymph node, metastasis shape II illness aliases those receiving ACT derived nan top endurance benefit.

Conclusions

EOPC patients grounds superior endurance pursuing NACT and surgical resection compared to AOPC, pinch ACT further enhancing outcomes successful this subgroup. These findings support nan usage of tailored ACT for EOPC and underscore nan request for prospective validation.