Comparison of neoadjuvant therapy versus upfront surgery in resectable pancreatic adenocarcinoma: a retrospective study
Bibliographic record
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive solid tumors and ranks as the fourth leading cause of cancer-related death in Western nations. The aim of the current study was to compare upfront surgery (US) and neoadjuvant therapy (NAT) in patients with resectable PDAC in terms of perioperative outcomes, early and late complications, overall survival, the recurrence rate, and readmission. Materials and Methods: In this study, all patients who underwent US or NAT for resectable pancreatic adenocarcinoma between January 2006 and March 2021 were retrospectively identified from institutional databases. Results: The NAT and US groups included 63 and 113 patients. The NAT group had significantly higher rates of arterial and venous resection and distal and total pancreatectomy, but no significant differences in anastomosis technique, pathology, margin status, invasion, stage, or early/late complications. The US group had significantly longer mean overall survival (63.66 vs. 34.10 months, p = 0.007) and higher 1-year (79.6% vs. 60.3%, p = 0.006) and 3-year (69.0% vs. 41.3%, p<0.001) survival rates, though 5-year survival was similar (p = 0.215). However, in the multivariate Cox regression analysis, the type of intervention (US or NAT) was not independently associated with poor overall survival (p value = 0.584). Recurrence and readmission rates were also comparable (p = 0.234 and 0.377, respectively). Conclusion: Our study revealed that US and NAT do not differ in terms of overall survival, recurrence, readmission, and early and late complications; however, given that the NAT group had worse prognosis, our findings suggest that NAT may provide a survival benefit for high-risk patients suffering from resecteable PDAC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".