PMID- 32222340
OWN - NLM
STAT- MEDLINE
DCOM- 20210409
LR  - 20210409
IS  - 1424-3911 (Electronic)
IS  - 1424-3903 (Linking)
VI  - 20
IP  - 4
DP  - 2020 Jun
TI  - Impact of adjuvant therapy in patients with invasive intraductal papillary 
      mucinous neoplasms of the pancreas.
PG  - 722-728
LID - S1424-3903(20)30100-9 [pii]
LID - 10.1016/j.pan.2020.03.009 [doi]
AB  - BACKGROUND: There is limited data on the efficacy of adjuvant therapy (AT) in 
      patients with invasive intraductal papillary mucinous neoplasms of the pancreas 
      (IPMN). This single center retrospective cohort study aims to assess the impact 
      of AT on survival in these patients. METHODS: Patients undergoing surgery for 
      invasive IPMN between 1993 and 2018 were included in the study. We compared the 
      clinicopathologic features and evaluated overall survival (OS) using multivariate 
      Cox regression adjusting for adjuvant therapy, age, T and N stage, perineural and 
      lymphovascular invasion. We also assessed survival differences between surgery 
      alone and AT in node negative (N0) and node positive (N+) subgroups. RESULTS: 103 
      patients were included in the study; 69 underwent surgery alone while 34 also 
      received AT. Patients in the AT group were significantly younger, presented at 
      higher T and N stages and had more perineural and lymphovascular invasion. Median 
      OS in the surgery alone group was 134 months and 65 months in the AT group, 
      p = 0.052. On multivariate analysis, AT was not associated with improved OS; 
      hazard ratio (HR) = 1.03 (0.52-2.05). In N0 patients, compared to surgery alone, 
      AT was associated with a worse median OS (65 vs 167 months, p = 0.03), whereas in 
      N+ patients there was a non-significant improvement (50.5 vs 20.4 months, 
      p = 0.315). CONCLUSION: AT did not improve survival in the overall cohort even 
      after multivariate analysis. N0 patients have excellent survival, and AT should 
      probably be avoided in them, whereas it may be considered in patients with N+ 
      disease.
CI  - Copyright (c) 2020. Published by Elsevier B.V.
FAU - Rodrigues, Clifton
AU  - Rodrigues C
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Hank, Thomas
AU  - Hank T
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Qadan, Motaz
AU  - Qadan M
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Ciprani, Debora
AU  - Ciprani D
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Mino-Kenudson, Mari
AU  - Mino-Kenudson M
AD  - Department of Pathology, Massachusetts General Hospital and Harvard Medical 
      School, Boston, MA, USA.
FAU - Weekes, Colin D
AU  - Weekes CD
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Ryan, David P
AU  - Ryan DP
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Clark, Jeffrey W
AU  - Clark JW
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Allen, Jill N
AU  - Allen JN
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Hong, Theodore S
AU  - Hong TS
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Wo, Jennifer Y
AU  - Wo JY
AD  - Cancer Center, Massachusetts General Hospital, Boston, MA, USA; Department of 
      Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 
      USA.
FAU - Ferrone, Cristina R
AU  - Ferrone CR
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Warshaw, Andrew L
AU  - Warshaw AL
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Lillemoe, Keith D
AU  - Lillemoe KD
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA.
FAU - Fernandez-Del Castillo, Carlos
AU  - Fernandez-Del Castillo C
AD  - Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, USA. Electronic address: CFernandez@partners.org.
LA  - eng
PT  - Journal Article
DEP - 20200319
PL  - Switzerland
TA  - Pancreatology
JT  - Pancreatology : official journal of the International Association of 
      Pancreatology (IAP) ... [et al.]
JID - 100966936
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*therapeutic use
MH  - Chemotherapy, Adjuvant
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Intraductal Neoplasms/*drug therapy/surgery
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Adjuvant therapy
OT  - IPMN
OT  - Intraductal papillary mucinous neoplasms of the pancreas
OT  - Invasive IPMN
COIS- Declaration of competing interest All the authors state that there is no conflict 
      of interest.
EDAT- 2020/03/31 06:00
MHDA- 2021/04/10 06:00
CRDT- 2020/03/31 06:00
PHST- 2020/01/24 00:00 [received]
PHST- 2020/03/13 00:00 [revised]
PHST- 2020/03/15 00:00 [accepted]
PHST- 2020/03/31 06:00 [pubmed]
PHST- 2021/04/10 06:00 [medline]
PHST- 2020/03/31 06:00 [entrez]
AID - S1424-3903(20)30100-9 [pii]
AID - 10.1016/j.pan.2020.03.009 [doi]
PST - ppublish
SO  - Pancreatology. 2020 Jun;20(4):722-728. doi: 10.1016/j.pan.2020.03.009. Epub 2020 
      Mar 19.