Upfront Surgery versus Neoadjuvant Therapy for Resectable Pancreatic Cancer: Systematic Review and Bayesian Network Meta-analysis View Full Text


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Article Info

DATE

2019-12

AUTHORS

Alison Bradley, Robert Van Der Meer

ABSTRACT

Current treatment recommendations for resectable pancreatic cancer support upfront resection and adjuvant therapy. Randomized controlled trials offering comparison with the emerging neoadjuvant approach are lacking. This review aims to compare both treatment strategies for resectable pancreatic cancer. PubMed, MEDLINE, Embase, Cochrane Database and Cochrane Databases were searched for studies comparing neoadjuvant and surgery-first with adjuvant therapy for resectable pancreatic cancer. A Bayesian network meta-analysis was conducted using the Markov chain Monte Carlo method. Cochrane Collaboration's risk of bias, ROBINS-I and GRADE tools were used to assess quality and risk of bias of included trials. 9 studies compared neoadjuvant therapy and surgery-first with adjuvant therapy (n = 22,285). Aggregate rate (AR) of R0 resection for neoadjuvant therapy was 0.8008 (0.3636-0.9144) versus 0.7515 (0.2026-0.8611) odds ratio (O.R.) 1.27 (95% CI 0.60-1.96). 1-year survival AR for neoadjuvant therapy was 0.7969 (0.6061-0.9500) versus 0.7481 (0.4848-0.8500) O.R. 1.38 (95% CI 0.69-2.96). 2-year survival AR for neoadjuvant therapy was 0.5178 (0.3000-0.5970) versus 0.5131 (0.2727-0.5346) O.R. 1.26 (95% CI 0.94-1.74). 5-year AR survival for neoadjuvant therapy was 0.2069 (0.0323-0.3300) versus 0.1783 (0.0606-0.2300) O.R. 1.19 (95% CI 0.65-1.73). In conclusion neoadjuvant therapy may offer benefit over surgery-first and adjuvant therapy. However, further randomized controlled trials are needed. More... »

PAGES

4354

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41598-019-40951-6

    DOI

    http://dx.doi.org/10.1038/s41598-019-40951-6

    DIMENSIONS

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    PUBMED

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    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

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    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1038/s41598-019-40951-6'

    N-Triples is a line-based linked data format ideal for batch operations.

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    Turtle is a human-readable linked data format.

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    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1038/s41598-019-40951-6'


     

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