Table 4 Treatment aims/advantages of neoadjuvant therapy
surgeons | oncologists | |
|---|---|---|
Which treatment aims do you associate with neoadjuvant therapy for PDAC? | ||
increasing the size of the resection margin (in resectable or borderline resectable cancer) | 27/99 (27.3%) | 4/15 (26.7%) |
decreasing the risk of distant metastases after an apparently curative resection by a preoperative treatment | 27/99 (27.3%) | 6/15 (40%) |
increasing the R0 resection rate (e.g. in borderline resectable cancer) | 77/99 (77.8%) | 14/15 (93.3%) |
achieving resectability/disease stabilization in oligometastasized disease with the aim of surgical treatment | 16/99 (16.2%) | 2/15 (13.3%) |
achieving secondary resectability in locally unresectable disease | 54/99 (54.5%) | 9/15 (60%) |
Preoperative treatment of micrometastases | 35/99 (35.4%) | 10/15 (66.7%) |
What are the theoretical advantages of neoadjuvant over adjuvant treatment? | ||
better treatment tolerability of neoadjuvant treatment | 41/99 (41.4%) | 12/15 (80%) |
higher dosage possible during neoadjuvant treatment | 26/99 (26.3%) | 7/15 (46.7%) |
lower surgical complication rate after neoadjuvant treatment | 11/99 (11.1%) | 3/15 (20%) |
better oncological patient selection by neoadjuvant treatment | 83/99 (83.8%) | 13/15 (86.7%) |
better vascular supply of the tumor for neoadjuvant treatment | 24/99 (24.2%) | 6/15 (40%) |