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. 2022 Feb 9;14(4):868.
doi: 10.3390/cancers14040868.

Concepts and Outcomes of Perioperative Therapy in Stage IA-III Pancreatic Cancer-A Cross-Validation of the National Cancer Database (NCDB) and the German Cancer Registry Group of the Society of German Tumor Centers (GCRG/ADT)

Louisa Bolm  1   2 , Sergii Zemskov  3 , Maria Zeller  2 , Taisuke Baba  1 , Jorge Roldan  1 , Jon M Harrison  1 , Natalie Petruch  1   2 , Hiroki Sato  1 , Ekaterina Petrova  2 , Hryhoriy Lapshyn  2 , Ruediger Braun  2 , Kim C Honselmann  2 , Richard Hummel  2 , Oleksii Dronov  3 , Alexander V Kirichenko  4 , Monika Klinkhammer-Schalke  5 , Kees Kleihues-van Tol  5 , Sylke R Zeissig  6 , Dirk Rades  7 , Tobias Keck  2 , Carlos Fernandez-Del Castillo  1 , Ulrich F Wellner  2 , Rodney E Wegner  4
Affiliations

Concepts and Outcomes of Perioperative Therapy in Stage IA-III Pancreatic Cancer-A Cross-Validation of the National Cancer Database (NCDB) and the German Cancer Registry Group of the Society of German Tumor Centers (GCRG/ADT)

Louisa Bolm et al. Cancers (Basel). .

Abstract

(1) Background: The aim of this study is to assess perioperative therapy in stage IA-III pancreatic cancer cross-validating the German Cancer Registry Group of the Society of German Tumor Centers-Network for Care, Quality, and Research in Oncology, Berlin (GCRG/ADT) and the National Cancer Database (NCDB). (2) Methods: Patients with clinical stage IA-III PDAC undergoing surgery alone (OP), neoadjuvant therapy (TX) + surgery (neo + OP), surgery+adjuvantTX (OP + adj) and neoadjuvantTX + surgery + adjuvantTX (neo + OP + adj) were identified. Baseline characteristics, histopathological parameters, and overall survival (OS) were evaluated. (3) Results: 1392 patients from the GCRG/ADT and 29,081 patients from the NCDB were included. Patient selection and strategies of perioperative therapy remained consistent across the registries for stage IA-III pancreatic cancer. Combined neo + OP + adj was associated with prolonged OS as compared to neo + OP alone (17.8 m vs. 21.3 m, p = 0.012) across all stages in the GCRG/ADT registry. Similarly, OS with neo + OP + adj was improved as compared to neo + OP in the NCDB registry (26.4 m vs. 35.4 m, p < 0.001). (4) Conclusion: The cross-validation study demonstrated similar concepts and patient selection criteria of perioperative therapy across clinical stages of PDAC. Neoadjuvant therapy combined with adjuvant therapy is associated with improved overall survival as compared to either therapy alone.

Keywords: neoadjuvant therapy; pancreatic cancer; pancreatic surgery; perioperative therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Consort 2015 flowchart patient selection GCRG/ADT registry. (b) Consort 2015 flowchart patient selection NCDB registry.
Figure 2
Figure 2
(a) Overall survival in perioperative treatment regimens in clinical stage IA-III PDAC (GCRG/ADT registry). (b) Overall survival in perioperative treatment regimens in clinical stage IA-III PDAC (NCDB registry). PDAC: pancreatic ductal adenocarcinoma; OP: operation; neoadj.: neoadjuvant; adj.: adjuvant.
Figure 2
Figure 2
(a) Overall survival in perioperative treatment regimens in clinical stage IA-III PDAC (GCRG/ADT registry). (b) Overall survival in perioperative treatment regimens in clinical stage IA-III PDAC (NCDB registry). PDAC: pancreatic ductal adenocarcinoma; OP: operation; neoadj.: neoadjuvant; adj.: adjuvant.
Figure 3
Figure 3
(a) Overall survival in perioperative treatment regimens in clinical stage IA-IIA PDAC (NCDB registry). (b) Overall survival in perioperative treatment regimens in clinical stage IIB-III PDAC (NCDB registry). OP: operation; neoadj.: neoadjuvant; adj.: adjuvant.
Figure 3
Figure 3
(a) Overall survival in perioperative treatment regimens in clinical stage IA-IIA PDAC (NCDB registry). (b) Overall survival in perioperative treatment regimens in clinical stage IIB-III PDAC (NCDB registry). OP: operation; neoadj.: neoadjuvant; adj.: adjuvant.
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