# Survival benefit of adjuvant therapy completion with early initiation for patients with pancreatic ductal adenocarcinoma

## TL;DR

Starting and finishing adjuvant therapy early after surgery improves survival for pancreatic cancer patients.

## Contribution

Identifies early initiation and completion of adjuvant therapy as independent survival predictors in pancreatic cancer.

## Key findings

- Early initiation of adjuvant therapy was linked to better overall survival.
- Completing adjuvant therapy for 6 months improved survival rates significantly.
- Severe postoperative complications hindered early adjuvant therapy completion.

## Abstract

To evaluate the prognostic effect of initiation timing and completion of adjuvant therapy in patients with pancreatic ductal adenocarcinoma.

The medical records of patients with pancreatic ductal adenocarcinoma who underwent radical pancreatectomy between 2006 and 2022 at Hiroshima University were retrospectively reviewed. Patient characteristics, perioperative outcomes, clinicopathological factors, and survival rates were analyzed. Adjuvant indications were for all patients who had a good postoperative status as early as possible. Early initiation was defined as adjuvant initiation within 4 weeks after surgery, and completion was defined as a total of 6 months of administration.

In total, 444 (294, resectable; 150, borderline resectable or locally advanced) patients who received adjuvant therapy were enrolled in this study. The median time to adjuvant therapy initiation was 20 days. In total, 328 patients with early initiation had better overall survival than those with delayed initiation, and 409 patients with adjuvant completion had better survival rates than those with incompletion. Multivariate overall survival analysis demonstrated that early adjuvant therapy initiation and completion were independent prognostic factors for prolonged survival. In total, 310 adjuvant completions with early initiation resulted in a median survival period of 81.8 months. Multivariate analysis identified severe postoperative complication as an independent risk factor preventing adjuvant completion with early initiation.

Adjuvant completion with early initiation may contribute to the improved survival of patients with pancreatic ductal adenocarcinoma. Preventing severe postoperative complications may facilitate adjuvant completion with early initiation.

Adjuvant completion with early initiation may contribute to the improved survival of patients with pancreatic ductal adenocarcinoma.