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Impact of neoadjuvant therapy on short-term outcomes after left pancreatectomy : A propensity score–matched international multicenter study

Bonsdorff, Akseli ; Kjeseth, Trond ; Sahakyan, Mushegh ; Kirkegård, Jakob ; de Ponthaud, Charles ; Ghorbani, Poya ; Wennerblom, Johanna ; Williamson, Caroline LU ; Acher, Alexandra W. and Thillai, Manoj , et al. (2025) In Surgery (United States) 185.
Abstract

Background: Neoadjuvant therapy is protective of postoperative pancreatic fistula in pancreatoduodenectomy. However, the effect of neoadjuvant therapy after left pancreatectomy remains unclear. The aim of this international multicenter study was to evaluate the impact of neoadjuvant therapy on short term outcomes after left pancreatectomy for pancreatic ductal adenocarcinoma. Methods: Patients undergoing left pancreatectomy from January 2010 to April 2023 at 9 high-volume centers were included. Patients treated with neoadjuvant therapy were compared to patients with upfront surgery. Propensity score matching in 1:1 fashion was used. The primary outcome was postoperative pancreatic fistula. Results: Six-hundred-fifty patients underwent... (More)

Background: Neoadjuvant therapy is protective of postoperative pancreatic fistula in pancreatoduodenectomy. However, the effect of neoadjuvant therapy after left pancreatectomy remains unclear. The aim of this international multicenter study was to evaluate the impact of neoadjuvant therapy on short term outcomes after left pancreatectomy for pancreatic ductal adenocarcinoma. Methods: Patients undergoing left pancreatectomy from January 2010 to April 2023 at 9 high-volume centers were included. Patients treated with neoadjuvant therapy were compared to patients with upfront surgery. Propensity score matching in 1:1 fashion was used. The primary outcome was postoperative pancreatic fistula. Results: Six-hundred-fifty patients underwent resection due to pancreatic ductal adenocarcinoma, of which 70 patients (10.8%) received neoadjuvant therapy. In the matched cohort (upfront surgery, 66 patients; neoadjuvant therapy, 66 patients), the rate of postoperative pancreatic fistula was similar in patients undergoing upfront surgery versus patients receiving neoadjuvant therapy (16 [24.2%] vs 13 [19.7%], P = .674, respectively). No statistically significant differences were observed between neoadjuvant therapy and upfront surgery group with respect to grade C-POPF, readmission, reoperation, postpancreatectomy hemorrhage, 90-day mortality, and severe complications. Conclusion: Neoadjuvant therapy was not associated with decreased rate of postoperative pancreatic fistula in patients undergoing left pancreatectomy.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Surgery (United States)
volume
185
article number
109552
publisher
Elsevier
external identifiers
  • scopus:105010436691
  • pmid:40669154
ISSN
0039-6060
DOI
10.1016/j.surg.2025.109552
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s)
id
f7929a20-4ca1-4db5-9577-eff584690412
date added to LUP
2025-11-20 15:25:09
date last changed
2025-12-18 18:34:11
@article{f7929a20-4ca1-4db5-9577-eff584690412,
  abstract     = {{<p>Background: Neoadjuvant therapy is protective of postoperative pancreatic fistula in pancreatoduodenectomy. However, the effect of neoadjuvant therapy after left pancreatectomy remains unclear. The aim of this international multicenter study was to evaluate the impact of neoadjuvant therapy on short term outcomes after left pancreatectomy for pancreatic ductal adenocarcinoma. Methods: Patients undergoing left pancreatectomy from January 2010 to April 2023 at 9 high-volume centers were included. Patients treated with neoadjuvant therapy were compared to patients with upfront surgery. Propensity score matching in 1:1 fashion was used. The primary outcome was postoperative pancreatic fistula. Results: Six-hundred-fifty patients underwent resection due to pancreatic ductal adenocarcinoma, of which 70 patients (10.8%) received neoadjuvant therapy. In the matched cohort (upfront surgery, 66 patients; neoadjuvant therapy, 66 patients), the rate of postoperative pancreatic fistula was similar in patients undergoing upfront surgery versus patients receiving neoadjuvant therapy (16 [24.2%] vs 13 [19.7%], P = .674, respectively). No statistically significant differences were observed between neoadjuvant therapy and upfront surgery group with respect to grade C-POPF, readmission, reoperation, postpancreatectomy hemorrhage, 90-day mortality, and severe complications. Conclusion: Neoadjuvant therapy was not associated with decreased rate of postoperative pancreatic fistula in patients undergoing left pancreatectomy.</p>}},
  author       = {{Bonsdorff, Akseli and Kjeseth, Trond and Sahakyan, Mushegh and Kirkegård, Jakob and de Ponthaud, Charles and Ghorbani, Poya and Wennerblom, Johanna and Williamson, Caroline and Acher, Alexandra W. and Thillai, Manoj and Tarvainen, Timo and Uutela, Aki and Sirén, Jukka and Kokkola, Arto and Hagen, Rolf E. and Lund, Andrea and Nielsen, Mette Fugleberg and Fristedt, Richard and Biörserud, Christina and Bratlie, Svein Olav and Tingstedt, Bobby and Labori, Knut J. and Gaujoux, Sébastien and Wigmore, Stephen J. and Hallet, Julie and Sparrelid, Ernesto and Kleive, Dyre and Sallinen, Ville}},
  issn         = {{0039-6060}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Surgery (United States)}},
  title        = {{Impact of neoadjuvant therapy on short-term outcomes after left pancreatectomy : A propensity score–matched international multicenter study}},
  url          = {{http://dx.doi.org/10.1016/j.surg.2025.109552}},
  doi          = {{10.1016/j.surg.2025.109552}},
  volume       = {{185}},
  year         = {{2025}},
}