ArticleAsian Pacific journal of cancer prevention : APJCP2025
Survival Outcomes in Nonmetastatic pT4 Pancreatic Ductal Adenocarcinoma: A SEER Database Analysis Comparing Neoadjuvant Therapy and Upfront Surgery with Propensity Score Matching.
Article in Asian Pacific journal of cancer prevention : APJCP, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGiven the increasing use of neoadjuvant therapy (NAT) for localized pancreatic ductal adenocarcinoma (PDAC), this study aimed to evaluate the survival outcomes of patients with pathological T4 (pT4) PDAC who received NAT followed by resection versus those who underwent upfront surgery.
methodsWe conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015) to compare survival outcomes of T4N0-XM0 PDAC patients in NAT and upfront surgery groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves and Cox regression analyses were employed to assess overall survival (OS) and identify prognostic factors. Subgroup analyses were conducted within the NAT cohort to determine the impact of different NAT modalities, adjuvant therapy (AT), lymph node yield (LNY), and lymph node ratio (LNR) on OS in this cohort.
resultsOf 8950 pT4 PDAC patients identified, 654 met the inclusion criteria (241 NAT vs. 413 upfront surgery). After PSM, 152 well-matched pairs remained. The median survival times were 26 months for NAT and 12 months for upfront surgery (P < 0.001). NAT was associated with significantly improved OS at all time points. Multivariate analysis identified NAT (P < 0.001) and AT (P = 0.002) as independent prognostic factors of improved OS. No significant OS difference was observed between neoadjuvant chemotherapy and chemoradiotherapy or between NAT with and without AT. Subgroup analysis revealed no significant difference in OS based on LNY cutoff values in either node-negative or node-positive cohorts but worse OS in node-positive patients with LNR ≥ 0.1 (P = 0.003).
conclusionsNAT followed by resection significantly improves OS in patients with pT4 PDAC, even in the absence of complete pathological downstaging.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.