{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:49:00Z","timestamp":1792464540426,"version":"4.5.0"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Adjuvant chemotherapy regimens may be administered after pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasms (A-IPMNs), although the evidence supporting their use is limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the survival benefit associated with contemporary adjuvant chemotherapy regimens after resection in A-IPMNs between 2017 and 2023.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study was an international, multicenter study with 69 participating centers across Europe, North America, South America, and the Asia-Pacific region. Patients undergoing resection for A-IPMNs were included. Data were analyzed from May to August 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Contemporary adjuvant chemotherapy regimens, such as gemcitabine-capecitabine (GemCap); 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFIRINOX), modified FOLFIRINOX (mFOLFIRINOX), and S-1.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measure<\/jats:title>\n Overall survival (months).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1321 patients (median [IQR] age 70 [63 to 76] years; 713 males [54.0%] and 608 females [46.0%]), 781 patients (59.1%) received adjuvant chemotherapy, while in 181 patients (13.7%) it was omitted due to poor patient fitness. Of patients who received adjuvant chemotherapy, 568 patients (72.6%) received contemporary regimens, including GemCap (232 patients [29.7%]), FOLFIRINOX (176 patients [22.5%]), mFOLFIRINOX (71 patients [9.1%]), and S-1 (70 patients [9.0%]). The median (IQR) follow-up for the cohort was 64.2 (40.4 to 85.0) months, and the median overall survival was 73.8 months (95% CI, 66.4 to 81.9 months). After 90-day landmark analysis and exclusion of patients ineligible for chemotherapy, adjuvant chemotherapy vs no adjuvant chemotherapy (propensity score\u2013matched populations, 243:243 patients) was not associated with improved overall survival (median, 82.3 months; 95% CI, 78.2 months to not applicable [NA] vs not reached; 95% CI, 75.3 months to NA;\n P<\/jats:italic>\n \u2009=\u2009.58). Contemporary regimens vs no adjuvant chemotherapy (propensity score\u2013matched populations, 309:309 patients) was not associated with longer survival, and a mean survival benefit greater than 4.2 months over 5 years was excluded (difference in restricted mean survival, 1.26 months; 95%, \u22121.72 to 4.24 months). Treatment outcomes did not vary by chemotherapy regimen or disease characteristic (eg, N stage or carbohydrate antigen 19-9 level).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, contemporary adjuvant chemotherapy was not associated with improved overall survival in A-IPMNs, and a randomized clinical trial is indicated.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.3688","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:30:39Z","timestamp":1774625439000},"page":"e263688","source":"Crossref","is-referenced-by-count":2,"title":["Contemporary Adjuvant Chemotherapy for Intraductal Papillary Mucinous Neoplasms"],"prefix":"10.1001","volume":"9","author":[{"given":"James","family":"Lucocq","sequence":"first","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery, Royal Infirmary of Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Haugk","sequence":"additional","affiliation":[{"name":"Department of Hepato-Pancreato-Biliary and Transplant Surgery, Freeman Hospital, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"White","sequence":"additional","affiliation":[{"name":"Department of Hepato-Pancreato-Biliary and Transplant Surgery, Freeman Hospital, Newcastle, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Marchegiani","sequence":"additional","affiliation":[{"name":"Hepatopancreatobiliary and Liver Transplant Surgery, Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska 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