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Factors associated with mortality in pancreatic adenocarcinoma patients achieving pathologic complete response after neoadjuvant therapy
Journal article   Peer reviewed

Factors associated with mortality in pancreatic adenocarcinoma patients achieving pathologic complete response after neoadjuvant therapy

Mohammed O. Suraju, Brian Longbottom, Jasmine A. Peteson, Terry Hayes, Kiers Brevik, Sean Y. Kim, Adrienne Davis, Paolo Goffredo, Imran Hassan, Hassan Aziz, …
The American journal of surgery, Vol.260, 117093
10/2026
DOI: 10.1016/j.amjsurg.2026.117093
PMID: 42296646

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Abstract

Factors influencing mortality among pancreatic ductal adenocarcinoma (PDAC) patients who achieve pathologic complete response (pCR) following neoadjuvant therapy have not been previously well studied. Adult PDAC patients (2006-2021) who received neoadjuvant were identified in the National Cancer Database. Tumor response was categorized as pCR if final specimen was pT0N0. Patients with positive margins and stage IV disease were excluded. Of 13,089 eligible patients, there were 207 patients who achieved pCR. The 3-year overall survival was 75% [69-81] for the entire cohort and did not differ significantly by clinical stage at diagnosis. Increased length of stay was the only factor associated with increased risk of mortality (HR 1.05 [95% CI: 1.02-1.09, P < 0.01]) in multivariable analysis. Among PDAC patients who achieve pCR, postoperative morbidity rather than initial disease stage appears to be the primary driver of long-term survival, informing prognostication for this unique subset of patients. •PDAC patients who achieve pCR after neoadjuvant therapy experience improved survival compared with those who do not.•Clinical stage at diagnosis was not associated with mortality risk after pathologic complete response was achieved.•LOS was the only factor independently associated with mortality risk in patients who achieved pCR.

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