The benefit of adjuvant radiotherapy on overall survival in resected stage I to II pancreatic cancer: A propensity-adjusted analysis
The survival time of patients with early pancreatic cancer (PC) is still disappointing, even after surgical resection. PC has an extremely poor prognosis. Herein, we aimed to investigate the survival effect of postoperative radiotherapy (PORT) on resected stage I to II PC. A large eligible sample of...
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| description | The survival time of patients with early pancreatic cancer (PC) is still disappointing, even after surgical resection. PC has an extremely poor prognosis. Herein, we aimed to investigate the survival effect of postoperative radiotherapy (PORT) on resected stage I to II PC.
A large eligible sample of patients was identified from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) registry. Survival analysis was conducted to evaluate the efficiency of PORT. Propensity score matching (PSM) analysis was used to reduce selection bias and to make the groups comparable.
A total of 3219 patients with resected stage I to II PC was included after rigid screening. The median overall survival (OS) was 26 months with PORT (n = 1055) versus 21 months with non-PORT (n = 2164) before matching (p |
| doi_str_mv | 10.1371/journal.pone.0243170 |
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A large eligible sample of patients was identified from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) registry. Survival analysis was conducted to evaluate the efficiency of PORT. Propensity score matching (PSM) analysis was used to reduce selection bias and to make the groups comparable.
A total of 3219 patients with resected stage I to II PC was included after rigid screening. The median overall survival (OS) was 26 months with PORT (n = 1055) versus 21 months with non-PORT (n = 2164) before matching (p<0.001). By multivariable analysis, PORT remained a favorable prognostic predictor for OS. In PSM analysis, receiving PORT was associated with improved OS (median, 26 months vs. 23 months; at 2 years, 51.7% vs. 46.7%; at 5 years, 23.3% vs. 17.4% (P = 0.006). After further meticulous exploration, only the stage IIB subgroup benefited from PORT (p<0.001). This result was due to the positive lymph node state (N+), whose mortality risk was cut by 23.4% (p<0.001) by PORT.
Addition of PORT to the treatment of patients with resected stage I to II PC conveys a survival benefit, particularly among those with N-positive or stage IIB disease.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0243170</identifier><identifier>PMID: 33315874</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adenocarcinoma - surgery ; Adjuvant treatment ; Aged ; Biology and Life Sciences ; Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Clinical medicine ; Combined Modality Therapy ; Epidemiology ; Female ; Hospitals ; Humans ; Kaplan-Meier Estimate ; Lymph nodes ; Male ; Matching ; Medical technology ; Medicine ; Medicine and Health Sciences ; Methods ; Multivariate Analysis ; Neoplasm Staging ; Oncology ; Pancreatic cancer ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - radiotherapy ; Pancreatic Neoplasms - surgery ; Patient outcomes ; Patients ; Population ; Propensity Score ; Radiation therapy ; Radiotherapy ; Radiotherapy, Adjuvant ; SEER Program ; Subgroups ; Surgery ; Survival ; Survival Analysis</subject><ispartof>PloS one, 2020-12, Vol.15 (12), p.e0243170</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Lin et al 2020 Lin et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-399c0b51a07c127ad95819c4098e8502443de6badc649495724c212aebbc47893</citedby><cites>FETCH-LOGICAL-c692t-399c0b51a07c127ad95819c4098e8502443de6badc649495724c212aebbc47893</cites><orcidid>0000-0002-2184-577X ; 0000-0003-4987-4975</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735624/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735624/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33315874$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Kimple, Randall J.</contributor><creatorcontrib>Lin, Zhuang-Bin</creatorcontrib><creatorcontrib>Song, Jian-Yuan</creatorcontrib><creatorcontrib>Li, An-Chuan</creatorcontrib><creatorcontrib>Chen, Cheng</creatorcontrib><creatorcontrib>Huang, Xiao-Xue</creatorcontrib><creatorcontrib>Xu, Ben-Hua</creatorcontrib><title>The benefit of adjuvant radiotherapy on overall survival in resected stage I to II pancreatic cancer: A propensity-adjusted analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The survival time of patients with early pancreatic cancer (PC) is still disappointing, even after surgical resection. PC has an extremely poor prognosis. Herein, we aimed to investigate the survival effect of postoperative radiotherapy (PORT) on resected stage I to II PC.
A large eligible sample of patients was identified from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) registry. Survival analysis was conducted to evaluate the efficiency of PORT. Propensity score matching (PSM) analysis was used to reduce selection bias and to make the groups comparable.
A total of 3219 patients with resected stage I to II PC was included after rigid screening. The median overall survival (OS) was 26 months with PORT (n = 1055) versus 21 months with non-PORT (n = 2164) before matching (p<0.001). By multivariable analysis, PORT remained a favorable prognostic predictor for OS. In PSM analysis, receiving PORT was associated with improved OS (median, 26 months vs. 23 months; at 2 years, 51.7% vs. 46.7%; at 5 years, 23.3% vs. 17.4% (P = 0.006). After further meticulous exploration, only the stage IIB subgroup benefited from PORT (p<0.001). This result was due to the positive lymph node state (N+), whose mortality risk was cut by 23.4% (p<0.001) by PORT.
Addition of PORT to the treatment of patients with resected stage I to II PC conveys a survival benefit, particularly among those with N-positive or stage IIB disease.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Adenocarcinoma - surgery</subject><subject>Adjuvant treatment</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Clinical medicine</subject><subject>Combined Modality Therapy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph nodes</subject><subject>Male</subject><subject>Matching</subject><subject>Medical technology</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - radiotherapy</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Population</subject><subject>Propensity Score</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>SEER Program</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7jr6D0QDguDFjPlom9YLYVj8KCws6OptOJOezmToNDVJB-feH27G6S5TUJBe5JA8583Je3qS5DmjCyYke7u1g-ugXfS2wwXlqWCSPkguWSn4POdUPDyLL5In3m8pzUSR54-TCyEEywqZXia_bjdIVthhYwKxDYF6O-yhC8RBbWzYoIP-QGxH7D6GbUv84PZmDy0xHXHoUQesiQ-wRlKRYElVkR467RCC0UTHEN07siS9sz123oTD_HiHP6ZBrP_gjX-aPGqg9fhsXGfJt48fbq8-z69vPlVXy-u5zkse5qIsNV1lDKjUjEuoy6xgpU5pWWCRRQtSUWO-glrnaZmWmeSp5owDrlY6lUUpZsnLk27fWq9GA73iqaSUUZmzSFQnorawVb0zO3AHZcGoPxvWrRW4-LAWVVZKzosiykKd1iiLgoMQgLLJdMOYjlrvx9uG1Q5rjV2IDk5Epyed2ai13SspRZbHhs6SV6OAsz8G9OEfJY_UGmJVpmtsFNM747Va5mnsuGCcR2rxFyp-Ne6Mtsf-x_1JwptJQmQC_gxrGLxX1dcv_8_efJ-yr8_YDUIbNt62QzC281MwPYHaWe8dNvfOMaqOE3DnhjpOgBonIKa9OHf9Punulxe_AZmSAWY</recordid><startdate>20201214</startdate><enddate>20201214</enddate><creator>Lin, Zhuang-Bin</creator><creator>Song, Jian-Yuan</creator><creator>Li, An-Chuan</creator><creator>Chen, Cheng</creator><creator>Huang, Xiao-Xue</creator><creator>Xu, Ben-Hua</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2184-577X</orcidid><orcidid>https://orcid.org/0000-0003-4987-4975</orcidid></search><sort><creationdate>20201214</creationdate><title>The benefit of adjuvant radiotherapy on overall survival in resected stage I to II pancreatic cancer: A propensity-adjusted analysis</title><author>Lin, Zhuang-Bin ; Song, Jian-Yuan ; Li, An-Chuan ; Chen, Cheng ; Huang, Xiao-Xue ; Xu, Ben-Hua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-399c0b51a07c127ad95819c4098e8502443de6badc649495724c212aebbc47893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Adenocarcinoma - surgery</topic><topic>Adjuvant treatment</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Clinical medicine</topic><topic>Combined Modality Therapy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph nodes</topic><topic>Male</topic><topic>Matching</topic><topic>Medical technology</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Methods</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - radiotherapy</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Population</topic><topic>Propensity Score</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>SEER Program</topic><topic>Subgroups</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Zhuang-Bin</creatorcontrib><creatorcontrib>Song, Jian-Yuan</creatorcontrib><creatorcontrib>Li, An-Chuan</creatorcontrib><creatorcontrib>Chen, Cheng</creatorcontrib><creatorcontrib>Huang, Xiao-Xue</creatorcontrib><creatorcontrib>Xu, Ben-Hua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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PC has an extremely poor prognosis. Herein, we aimed to investigate the survival effect of postoperative radiotherapy (PORT) on resected stage I to II PC.
A large eligible sample of patients was identified from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) registry. Survival analysis was conducted to evaluate the efficiency of PORT. Propensity score matching (PSM) analysis was used to reduce selection bias and to make the groups comparable.
A total of 3219 patients with resected stage I to II PC was included after rigid screening. The median overall survival (OS) was 26 months with PORT (n = 1055) versus 21 months with non-PORT (n = 2164) before matching (p<0.001). By multivariable analysis, PORT remained a favorable prognostic predictor for OS. In PSM analysis, receiving PORT was associated with improved OS (median, 26 months vs. 23 months; at 2 years, 51.7% vs. 46.7%; at 5 years, 23.3% vs. 17.4% (P = 0.006). After further meticulous exploration, only the stage IIB subgroup benefited from PORT (p<0.001). This result was due to the positive lymph node state (N+), whose mortality risk was cut by 23.4% (p<0.001) by PORT.
Addition of PORT to the treatment of patients with resected stage I to II PC conveys a survival benefit, particularly among those with N-positive or stage IIB disease.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33315874</pmid><doi>10.1371/journal.pone.0243170</doi><tpages>e0243170</tpages><orcidid>https://orcid.org/0000-0002-2184-577X</orcidid><orcidid>https://orcid.org/0000-0003-4987-4975</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Adenocarcinoma - surgery Adjuvant treatment Aged Biology and Life Sciences Cancer Cancer therapies Care and treatment Chemotherapy Clinical medicine Combined Modality Therapy Epidemiology Female Hospitals Humans Kaplan-Meier Estimate Lymph nodes Male Matching Medical technology Medicine Medicine and Health Sciences Methods Multivariate Analysis Neoplasm Staging Oncology Pancreatic cancer Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Pancreatic Neoplasms - radiotherapy Pancreatic Neoplasms - surgery Patient outcomes Patients Population Propensity Score Radiation therapy Radiotherapy Radiotherapy, Adjuvant SEER Program Subgroups Surgery Survival Survival Analysis |
| title | The benefit of adjuvant radiotherapy on overall survival in resected stage I to II pancreatic cancer: A propensity-adjusted analysis |
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