Neoadjuvant Therapy Before Pancreatic Cancer Surgery Reduces Readmission

The use of neoadjuvant chemotherapy (NAC) in patients with pancreatic cancer undergoing pancreatic resection was found to be associated with lower postoperative hospital readmission, according to new data.

Neoadjuvant therapies, which are administered prior to the primary treatment regimen, are increasingly utilized in the clinic, but data on this strategy for pancreatectomy for pancreatic cancer are limited, according to the study authors.

For this analysis, an international research team utilized the United States’ National Cancer Database to conduct a retrospective review of patients who underwent surgery for non-metastatic pancreatic ductal adenocarcinoma (PDAC) between 2004 and 2016. A total of 2,911 patients who received NAC prior to surgery were propensity matched to 2,911 patients who did not receive NAC, and a regression model was conducted to evaluate the association of NAC with length of stay (LOS), 30-day readmission, and 30- and 90-day mortality. A stratified analysis by surgery type, or pancreaticoduodenectomy (PD) versus distal pancreatectomy (DP), was also conducted.

Overall, the use of NAC prior to pancreatic resection was associated with a significant reduction in rates of 30-day readmission, or 5.5% versus 7.4% for the non-NAC cohort (odds ration [OR], 0.74; 95% confidence interval [CI], 0.60-0.92; P=0.006). The investigators did not find any significant differences in LOS and mortality between the two patient groups. Stratification by surgery type showed similar findings.

“Receipt of NAC in [patients with] PDAC undergoing DP or PD is associated with lower readmission rates and does not otherwise compromise short-term outcomes. These data reaffirm the safety of strategies incorporating NAC and is important to consider when devising policies aimed at quality improvement,” the researchers concluded.

This study was published in the Annals of Surgical Oncology.