Statistical cure fraction in patients with borderline resectable pancreatic ductal adenocarcinoma undergoing neoadjuvant therapy followed by radical resection: a secondary analysis of reconstructed individual patient data
10.4174/astr.2025.109.3.162
- Author:
Yong Hyun JANG
1
;
Ru Ri LEE
;
Yongkeun PARK
Author Information
1. Catholic Kwandong University College of Medicine, Incheon, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Annals of Surgical Treatment and Research
2025;109(3):162-168
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Although neoadjuvant therapy (NAT) has been applied in patients with borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC), limited data on long-term outcomes are available to support its role as a potentially curable therapeutic option. This study assessed the probability of being statistically cured among these patients.
Methods:The literature search was conducted focusing on previous studies that investigated the long-term recurrencefree survival rates of patients with BR-PDAC after NAT followed by radical resection. The reference cohort data were extracted from studies including patients undergoing upfront radical resection for resectable PDAC. Pseudo-individual patient data were reconstructed from the original papers. A non-mixture cure model was adopted to estimate the statistical cure fraction.
Results:Twelve retrospective studies reporting long-term recurrence-free survival after NAT followed by radical resection for patients with BR-PDAC were secondarily analyzed. The probability of being statistically cured in these patients was 8.1% (95% confidence interval [CI], 5.4%–11.5%), which was lower than that of the reference cohort of 5 retrospective studies (14.7%; 95% CI, 13.2%–16.4%). There was a statistically significant difference between the 2 groups (hazard ratio, 1.110;95% CI, 1.007–1.224). Conclusion: From this study, we concluded that a cure can be expected in around eight percent of patients with BR-PDAC after NAT followed by radical resection, which would be helpful in counseling patients, as well as deciding whether to perform the surgery.
