Factors associated with failure to complete adjuvant chemotherapy in pancreatic cancer

Am J Surg. 2016 Apr;211(4):787-92. doi: 10.1016/j.amjsurg.2015.10.034. Epub 2016 Jan 11.

Abstract

Background: The importance of completing adjuvant chemotherapy in pancreatic cancer is becoming recognized. However, the clinicopathological factors associated with failure to complete adjuvant chemotherapy remain unclear.

Methods: A total of 135 patients were analyzed to identify the factors associated with failure to complete adjuvant chemotherapy.

Results: Ninety patients completed planned adjuvant chemotherapy, whereas 45 patients failed to complete adjuvant chemotherapy. Lower preoperative prognostic nutritional index, intraoperative blood transfusion, and organ and/or space surgical site infection, and advanced tumor stage were associated with failure to complete adjuvant chemotherapy. Neoadjuvant chemoradiotherapy was associated with significantly lower prognostic nutritional index, less incidence of organ and/or space surgical site infection, and earlier tumor stage, suggesting the conflicting effects of neoadjuvant chemoradiotherapy on completing adjuvant chemotherapy.

Conclusions: Several clinicopathological factors including patient conditions and perioperative events were associated with failure to complete adjuvant chemotherapy.

Keywords: Adjuvant chemotherapy; Pancreatic cancer; Prognosis; Recurrence.

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blood Transfusion / statistics & numerical data
  • Chemotherapy, Adjuvant*
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Nutritional Status
  • Pancreatectomy
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Prognosis
  • Risk Factors
  • Surgical Wound Infection / epidemiology