Type of publication:
Conference abstract
Author(s):
Labib P.L.Z.; Alarabiyat M.; Powell-Brett S.; Hall L.; Rehman S.; Edwards D.; Ma Y.T.; Sivakumar S.; Good J.; Candish C.; Nagy A.; Hafeez T.; Kunene V.; *Chatterjee A.; Roberts K.J.; Chatzizacharias N.
Citation:
HPB. Conference: 17th World Congress of the International Hepato-Pancreato-Biliary Association. Singapore Singapore. 28(Supplement 2) (pp S746), 2026. Date of Publication: 01 Jan 2026.
Abstract:
Introduction: Pancreatic cancer (PC) treatment in the UK is coordinated via regional referral networks, but formal neoadjuvant chemotherapy (NAC) pathways for borderline resectable and locally advanced PC (BR/LAPC) are rare. This retrospective cohort study assessed intra-network variation in access to diagnostics, time to treatment, and patient outcomes following NAC for BR/LAPC in our network.
Method(s): All patients with BR/LAPC referred from regional network hospitals between 2017-2021 were reviewed. Data were collected on time from first diagnostic CT to endoscopy, commencement of NAC, NAC regimens administered and patient outcomes.
Result(s): In the 155 referred patients who commenced NAC, there were significant differences in median time from diagnosis to biliary drainage (p=0.008) and endoscopic ultrasound (p=0.017). Time from diagnosis to first administration of NAC was long (median 64 days; p=0.079). There were significant differences in the proportion of patients commenced on mFOLFIRINOX (0-100%, p< 0.001) and the proportion completing NAC (0-100%, p=0.012). Despite variations in use of mFOLFIRINOX and the proportion of patients completing the planned course of NAC, this did not translate into a significant difference in the likelihood of proceeding to surgical resection between centres. Size of the referral hospital and delays to completing diagnostics and commencing NAC were not associated with a reduced chance of undergoing resection (all >0.050).
Conclusion(s): There is significant intra-network variation in access to interventional endoscopy and choice of NAC regimen. Centralised tracking of patients, development of locally agreed treatment protocols and an update to national guidelines are needed to standardise NAC pathways for BR/LAPC. * Oral Poster & Electronic Poster presented.
DOI: 10.1016/j.hpb.2026.08.1098
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