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Added value of intra-operative ultrasound to determine the resectability of locally advanced pancreatic cancer following FOLFIRINOX chemotherapy (IMAGE): a prospective multicenter study.
van Veldhuisen, Eran; Walma, Marieke S; van Rijssen, L Bengt; Busch, Olivier R; Bruijnen, Rutger C G; van Delden, Otto M; Mohammad, Nadia Haj; de Hingh, Ignace H; Yo, Lonneke S; van Laarhoven, Hanneke W; van Leeuwen, Maarten S; Nio, C Yung; van Santvoort, Hjalmar C; de Vries, Jan; Wessels, Frank J; Wilmink, Johanna W; Molenaar, I Quintus; Besselink, Marc G; van Lienden, Krijn P.
Afiliação
  • van Veldhuisen E; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Walma MS; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Surgery, University Medical Center, Utrecht, the Netherlands.
  • van Rijssen LB; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Busch OR; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Bruijnen RCG; Department of Radiology, University Medical Center, Utrecht, the Netherlands.
  • van Delden OM; Department of Radiology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Mohammad NH; Department of Medical Oncology, University Medical Center, Utrecht, the Netherlands.
  • de Hingh IH; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
  • Yo LS; Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands.
  • van Laarhoven HW; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • van Leeuwen MS; Department of Radiology, University Medical Center, Utrecht, the Netherlands.
  • Nio CY; Department of Radiology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • van Santvoort HC; Department of Surgery, St Antonius Hospital Nieuwegein, University Medical Center Utrecht Cancer Center, Regional Academic Cancer Center Utrecht, the Netherlands.
  • de Vries J; Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, VU University, Amsterdam, the Netherlands.
  • Wessels FJ; Department of Radiology, University Medical Center, Utrecht, the Netherlands.
  • Wilmink JW; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Molenaar IQ; Department of Surgery, St Antonius Hospital Nieuwegein, University Medical Center Utrecht Cancer Center, Regional Academic Cancer Center Utrecht, the Netherlands.
  • Besselink MG; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • van Lienden KP; Department of Radiology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands. Electronic address: k.p.vanlienden@amc.nl.
HPB (Oxford) ; 21(10): 1385-1392, 2019 10.
Article em En | MEDLINE | ID: mdl-31010633
ABSTRACT

BACKGROUND:

Determining the resectability of locally advanced pancreatic cancer (LAPC) after FOLFIRINOX chemotherapy is challenging because CT-scans cannot reliably assess vascular involvement. This study evaluates the added value of intra-operative ultrasound (IOUS) in LAPC following FOLFIRINOX induction chemotherapy.

METHODS:

Prospective multicenter study in patients with LAPC who underwent explorative laparotomy with IOUS after FOLFIRINOX chemotherapy. Resectability was defined according to the National Comprehensive Cancer Network guidelines. IOUS findings were compared with preoperative CT-scans and pathology results.

RESULTS:

CT-staging in 38 patients with LAPC after FOLFIRINOX chemotherapy defined 22 patients LAPC, 15 borderline resectable and one resectable. IOUS defined 19 patients LAPC, 13 borderline resectable and six resectable. In 12/38 patients, IOUS changed the resectability status including five patients from borderline resectable to resectable and five patients from LAPC to borderline resectable. Two patients were upstaged from borderline resectable to LAPC. Tumor diameters were significantly smaller upon IOUS (31.7 ± 9.5 mm versus 37.1 ± 10.0 mm, p = 0.001) and resectability varied significantly (p = 0.043). Ultimately, 20 patients underwent resection of whom 14 were evaluated as (borderline) resectable on CT-scan, and 17 on IOUS.

DISCUSSION:

This prospective study demonstrates that IOUS may change the resectability status up to a third of patients with LAPC following FOLFIRINOX chemotherapy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatectomia / Neoplasias Pancreáticas / Protocolos de Quimioterapia Combinada Antineoplásica / Ultrassonografia / Estadiamento de Neoplasias Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatectomia / Neoplasias Pancreáticas / Protocolos de Quimioterapia Combinada Antineoplásica / Ultrassonografia / Estadiamento de Neoplasias Idioma: En Ano de publicação: 2019 Tipo de documento: Article