Your browser doesn't support javascript.
loading
Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy: A Single-Center Experience.
Theijse, Rutger T; Stoop, Thomas F; Leenart, Philip D; Lutchman, Kishan R D; Erdmann, Joris I; Daams, Freek; Zonderhuis, Babs M; Festen, Sebastiaan; Swijnenburg, Rutger-Jan; van Gulik, Thomas M; Schoorlemmer, Annuska; Sterk, André L A; van Dieren, Susan; Fariña, Arantza; Voermans, Rogier P; Wilmink, Johanna W; Kazemier, Geert; Busch, Olivier R; Besselink, Marc G.
Affiliation
  • Theijse RT; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Stoop TF; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Leenart PD; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Lutchman KRD; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Erdmann JI; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Daams F; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Zonderhuis BM; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Festen S; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Swijnenburg RJ; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • van Gulik TM; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Schoorlemmer A; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Sterk ALA; Department of Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands.
  • van Dieren S; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Fariña A; Department of Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands.
  • Voermans RP; Department of Surgery, OLVG, Amsterdam, The Netherlands.
  • Wilmink JW; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Kazemier G; Cancer Center Amsterdam, 1081 HV, Amsterdam, The Netherlands.
  • Busch OR; Department of Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands.
  • Besselink MG; Department of Surgery, Amsterdam UMC, Location University of Amsterdam, 1081 HV, Amsterdam, The Netherlands.
Ann Surg Oncol ; 31(9): 6180-6192, 2024 Sep.
Article in En | MEDLINE | ID: mdl-38954094
ABSTRACT

BACKGROUND:

The use of surgery in patients with locally advanced pancreatic cancer (LAPC) following induction chemotherapy is increasing. However, most series do not report on the total cohort of patients undergoing surgical exploration; therefore, this single-center study investigates outcomes among all consecutive patients with LAPC who underwent surgical exploration.

METHODS:

We conducted a retrospective, single-center analysis including all consecutive patients with LAPC (Dutch Pancreatic Cancer Group criteria) who underwent surgical exploration with curative intent (January 2014-June 2023) after induction therapy. Primary outcomes were resection rate and overall survival (OS) from the time of diagnosis.

RESULTS:

Overall, 127 patients underwent surgical exploration for LAPC, whereby 100 patients (78.7%) underwent resection and 27 patients (21.3%) underwent a non-therapeutic laparotomy due to the extent of vascular involvement (n = 11, 8.7%) or occult metastases (n = 16, 12.6%). The overall in-hospital/30-day mortality rate was 0.8% and major morbidity was 31.3% (in patients after resection 1.0% and 33.3%, respectively). The overall 90-day mortality rate was 5.5%, which included 3.1% mortality due to disease progression. Resection was associated with longer median OS {29 months (95% confidence interval [CI] 26-43) vs. 17 months (95% CI 11-26); p < 0.001} compared with patients undergoing non-therapeutic laparotomy, with corresponding 5-year OS rates of 28.4% and 7.7%. In Cox proportional hazard regression analysis, only pancreatic body/tail tumors independently predicted OS (hazard ratio 1.788 [95% CI 1.042-3.068]).

CONCLUSION:

This single-center series found a resection rate of 78.7% in patients with LAPC selected for surgical exploration, with a low risk of mortality and morbidity in all explored patients and a 5-year OS rate after resection of 28.4%.
Subject(s)
Key words

Full text: 1 Database: MEDLINE Main subject: Pancreatectomy / Pancreatic Neoplasms / Antineoplastic Combined Chemotherapy Protocols / Induction Chemotherapy Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Year: 2024 Type: Article

Full text: 1 Database: MEDLINE Main subject: Pancreatectomy / Pancreatic Neoplasms / Antineoplastic Combined Chemotherapy Protocols / Induction Chemotherapy Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Year: 2024 Type: Article