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Hospital admission during neoadjuvant therapy for pancreatic ductal adenocarcinoma: prevalence, predictors, and prognosis

Year: 2025

Type: article

Abstract: BACKGROUND: Neoadjuvant therapy (NT) is increasingly utilized for localized pancreatic ductal adenocarcinoma (PDAC). The incidence of hospital admission during NT and its impact on clinical outcomes is poorly understood. METHODS: Patients with localized PDAC who received intent-to-treat NT between 2018 and 2023 at a single institution were retrospectively reviewed. Hospital admission rates, reasons, and the impact on overall survival (OS) were assessed. RESULTS: Among 305 patients, 58.4 % were male, 90.7 % were white, and median age was 66. Patients had potentially resectable (31.1 %), borderline resectable (36.7 %), and locally advanced disease (32.1 %). The median duration of NT was 119 days. Overall, 80 (26.2 %) patients required hospital admission during NT (range 1-5). The most common reasons for admission were fever/infection (33.8 %) and gastrointestinal symptoms (20.8 %). Factors associated with hospital admission included LA anatomic stage (OR 2.56; 95%CI: 1.22-5.39; p = 0.013) and BMI (OR 1.09; 95%CI: 1.04-1.15; p < 0.001). Hospital admission was associated with reduced odds of undergoing surgical resection (OR 0.27; 95%CI: 0.14-0.54; p < 0.001) and worse OS (median 14.6 months; 95%CI: 11.3-18.0 vs 22.6 months; 95%CI: 17.2-28.1; p < 0.001). CONCLUSION: Hospital admission is common among patients with PDAC receiving NT and associated with worse outcomes. Further research on optimizing care delivery during NT is critical to improve outcomes.

Source: HPB

DOI: 10.1016/j.hpb.2025.08.015