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Practice Patterns and Survival in Patients with Resected Pancreatic Ductal Adenocarcinomas (PDAC) — Results from the Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP) Study

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Abstract

Background

There is limited data from India with regard to presentation, practice patterns and survivals in resected pancreatic ductal adenocarcinomas (PDACs).

Methods

The Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP) included data from 8 major academic institutions across India and presents the outcomes in upfront resected PDACs from January 2015 to June 2019.

Results

Of 288 patients, R0 resection was achieved in 81% and adjuvant therapy was administered in 75% of patients. With a median follow-up of 42 months (95% CI: 39–45), median DFS for the entire cohort was 39 months (95% CI: 25.4–52.5), and median overall survival (OS) was 45 months (95% CI: 32.3–57.7). A separate analysis was done in which patients were divided into 3 groups: (a) those with stage I and absent PNI (SI&PNI-), (b) those with either stage II/III OR presence of PNI (SII/III/PNI+), and (c) those with stage II/III AND presence of PNI (SII/III&PNI+). The DFS was significantly lesser in patients with SII/III&PNI+ (median 25, 95% CI: 14.1–35.9 months), compared to SII/III/PNI + (median 40, 95% CI: 24–55 months) and SI&PNI- (median, not reached) (p = 0.036)).

Conclusions

The MIPPAP study shows that resectable PDACs in India have survivals at par with previously published data. Adjuvant therapy was administered in 75% patients. Adjuvant radiotherapy does not seem to add to survival after R0 resection.

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Authors and Affiliations

  1. Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India

    Vikram Chaudhari, Anant Ramaswamy, Sujay Srinivas, Prabhat Bhargava, Amit Gupta, Anbarasan Sekar, Manish Bhandare, Shailesh V. Shrikhande & Vikas Ostwal

  2. Balco Medical Centre Raipur India, Uparwara, Raipur, India

    Ajit Agarwal

  3. Cancer Institute WIA, Chennai, India

    Ramakrishnan Ayloor Seshadri

  4. Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India

    Vineet Talwar, Shaifali Goel, Varun Goel & Shivendra Singh

  5. Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India

    Smita Kayal

  6. Asian Institute of Gastroenterology, Hyderabad, India

    Pradeep Rebala

  7. HCG Cancer Hospital, Ahmedabad, India

    Bharat Prajapati, Devendra Parikh, Jagdish Kothari & Viraj Lavingia

  8. Lakeshore Hospital & Research Center, Kochi, Kerala, India

    Ramesh M. Ch & Jacob Mathew Kadamapuzha

  9. Medanta The Medicity, Gurugram, India

    Deeksha Kapoor & Adarsh Chaudhary

  10. Tata Medical Center, Kolkata, India

    Joydeep Ghosh

  11. All India Institute of Medical Sciences, Jodhpur, India

    Sanjeev Misra, Jeewan Ram Vishnoi, Subhash Soni, Vaibhav Kumar Varshney & Sandeep Bairwa

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  1. Vikram Chaudhari
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  2. Anant Ramaswamy
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  31. Vikas Ostwal
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Contributions

All authors contributed equally to the manuscript. Concept and data analysis: VO, AR, VC.

Corresponding author

Correspondence to Vikas Ostwal.

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Chaudhari, V., Ramaswamy, A., Srinivas, S. et al. Practice Patterns and Survival in Patients with Resected Pancreatic Ductal Adenocarcinomas (PDAC) — Results from the Multicentre Indian Pancreatic & Periampullary Adenocarcinoma Project (MIPPAP) Study. J Gastrointest Canc 54, 1338–1346 (2023). https://doi.org/10.1007/s12029-023-00936-1

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