Neoadjuvant therapy versus upfront surgery for potentially resectable pancreatic cancer: A Markov decision analysis

PloS One
Alison Bradley, Robert Van Der Meer

Abstract

Neoadjuvant therapy has emerged as an alternative treatment strategy for potentially resectable pancreatic cancer. In the absence of large randomized controlled trials offering a direct comparison, this study aims to use Markov decision analysis to compare efficacy of traditional surgery first (SF) and neoadjuvant treatment (NAT) pathways for potentially resectable pancreatic cancer. An advanced Markov decision analysis model was constructed to compare SF and NAT pathways for potentially resectable pancreatic cancer. Transition probabilities were calculated from randomized control and Phase II/III trials after comprehensive literature search. Utility outcomes were measured in overall and quality-adjusted life months (QALMs) on an intention-to-treat basis as the primary outcome. Markov cohort analysis of treatment received was the secondary outcome. Model uncertainties were tested with one and two-way deterministic and probabilistic Monte Carlo sensitivity analysis. SF gave 23.72 months (18.51 QALMs) versus 20.22 months (16.26 QALMs). Markov Cohort Analysis showed that where all treatment modalities were received NAT gave 35.05 months (29.87 QALMs) versus 30.96 months (24.86QALMs) for R0 resection and 34.08 months (29.87 QALMs) ...Continue Reading

References

Nov 22, 2001·Lancet·J P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
May 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Peter W T PistersDouglas B Evans
Sep 10, 2002·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·V MoutardierJ R Delpero
Mar 26, 2003·International Journal of Radiation Oncology, Biology, Physics·Valerie MagninJean Robert Delpero
Dec 10, 2003·American Journal of Clinical Oncology·Sana Al-SukhunAnthony F Shields
Mar 19, 2004·The New England Journal of Medicine·John P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Sep 21, 2004·Psychonomic Bulletin & Review·Jeffrey N Rouder, Paul L Speckman
Feb 24, 2006·Japanese Journal of Clinical Oncology·Tomoo KosugeUNKNOWN Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer (JSAP)
Jun 26, 2007·World Journal of Gastroenterology : WJG·Pälvi VentoTuula Kiviluoto
Jan 15, 2008·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·H GolcherT Meyer
May 20, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Stefan HeinrichPierre-Alain Clavien
Jul 22, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gauri R VaradhacharyDouglas B Evans
Jul 22, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Douglas B EvansRobert A Wolff
Oct 1, 2008·Cancer·Hideyuki YoshitomiUNKNOWN Pancreatic Cancer Chemotherapy Program of the Chiba University Department of General Surgery Affiliated Hospital Group
Mar 31, 2009·International Archives of Medicine·Doaa W MaximousAlaa A Abd-Elsayed
May 12, 2009·International Journal of Radiation Oncology, Biology, Physics·Gian C MattiucciNuma Cellini
Jul 22, 2009·PLoS Medicine·David MoherUNKNOWN PRISMA Group
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherUNKNOWN PRISMA Group
Sep 9, 2010·JAMA : the Journal of the American Medical Association·John P NeoptolemosUNKNOWN European Study Group for Pancreatic Cancer
Sep 15, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean-Luc Van LaethemKarin Haustermans
Dec 7, 2010·World Journal of Surgery·David LjungmanAnders Hyltander

❮ Previous
Next ❯

Citations

Feb 4, 2021·Annals of Gastroenterological Surgery·Keinosuke IshidoTaiichi Wakiya
Jan 9, 2021·Annals of Surgical Oncology·Jin HeMarco Del Chiaro
Jul 8, 2021·Journal of Surgical Oncology·Caroline J RieserAmer H Zureikat
Aug 28, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Minsig ChoiEugene Feinberg

❮ Previous
Next ❯

Methods Mentioned

BETA
surgical resection

Software Mentioned

ROBINS Risk of Interventions
NAT
TreeAge
TreeAge Pro

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
S W L de GeusJ F Tseng
Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
Oliver Strobel, M W Büchler
Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
Oliver Strobel, M W Büchler
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Joseph R AcevedoJames D Murphy
© 2022 Meta ULC. All rights reserved