Authors
Devanshi D Patel, Hamidreza Hosseinpour, Ahmad B Abdulkarim, Huibo Shao, Stephen W Behrman
Published in
HPB : the official journal of the International Hepato Pancreato Biliary Association. Oct 15, 2026. Epub Oct 15, 2026.
Abstract
Evidence comparing neoadjuvant chemoradiation (nCRT) with chemotherapy alone (nCT) for pancreatic ductal adenocarcinoma (PDAC) primarily concerns pancreatic head tumors. This study evaluated outcomes after distal resection.
The National Cancer Database was retrospectively reviewed for patients undergoing distal pancreatectomy and splenectomy following neoadjuvant therapy for PDAC during 2005-2019. Outcomes included pathologic downstaging, disease progression, and overall survival.
Among 284 patients, 142 received each treatment. Baseline characteristics were comparable, although nCRT patients had higher clinical stage (p = 0.004). Overall, pathologic downstaging occurred in 36.3% of all patients. Compared with nCT, nCRT was associated with greater pathologic downstaging (47.2% versus 25.4%; p < 0.001) and less disease progression (7.7% versus 19%; p = 0.005). On multivariable analysis, nCRT was associated with increased odds of downstaging (adjusted OR 2.57, 95% CI 1.55-4.27; p < 0.001) and decreased odds of progression (adjusted OR 0.44, 95% CI 0.34-0.72; p = 0.004). Overall survival was longer with nCRT (35 versus 27 months; adjusted HR 0.74, 95% CI 0.56-0.99; p = 0.039).
Among patients undergoing distal resection for PDAC, nCRT was associated with improved pathologic response, reduced progression, and longer survival compared with nCT. These findings support considering radiation within multidisciplinary treatment of pancreatic body and tail tumors and highlight the need for prospective trials.
PMID:
42966682
Bibliographic data and abstract were imported from PubMed on 01 Nov 2026.
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