Intention to treat outcomes following management of locally advanced pancreatic ductal adenocarcinoma with curative intent: single centre cohort study.

Authors

Moath Alarabiyat, Saad Rehman, Peter L Labib, Sarah Powell-Brett, Lewis Hall, Dawn Edwards, Yuk T Ma, Shivan Sivakumar, James Good, Soulat S Raza, Bobby Dasari, Ravi Marudanayagam, David Bartlett, Keith J Roberts, Robert Sutcliffe, Pancreatic Cancer Neoadjuvant Therapy Audit Collaborative, Nikolaos Chatzizacharias

Published in

HPB : the official journal of the International Hepato Pancreato Biliary Association. Jun 20, 2026. Epub Jun 20, 2026.

Abstract

Advances in the management of locally advanced pancreatic ductal adenocarcinoma (LAPDAC) have resulted in only a modest improvement in outcomes. This study highlights treatment pathway and outcomes of the largest contemporary United Kingdom LAPDAC cohort to date.
LAPDAC patients between 01/2017-12/2022 were included. Patient and tumour characteristics, surgical and oncological outcomes were collected prospectively. Primary endpoint was overall survival (OS). Secondary endpoints were chemotherapy completion and resection rates, perioperative morbidity and mortality and disease-free survival (DFS).
208 patients were included. 133 patients commenced neoadjuvant treatment (NAT) with 107 patients receiving at least 3 months and 65 completing 6 months. 44/133 (33%) patients were considered for surgery and 25 (19%) underwent resection. 80% of patients underwent venous and/or arterial resection. 52% of patients had R0 resection. 90-day mortality was 12%. Median OS was significantly longer for patients who had resection after NAT (12.6 months vs 30 months, P < 0.001). Median DFS was 7.7 months with a 3-year rate of 14%. Completion of chemotherapy (6 months) was associated with prolonged OS.
Multimodality therapy that includes surgery can be accomplished in selected patients with LAPDAC and is associated with a median overall survival that approximates earlier stages of disease.

PMID:
42401500
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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