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Adjuvant chemotherapy for adenocarcinoma arising from intraductal papillary mucinous neoplasia: multicentre ADENO-IPMN study.
Lucocq, James; Hawkyard, Jake; Haugk, Beate; Mownah, Omar; Menon, Krishna; Furukawa, Takaki; Inoue, Yosuke; Hirose, Yuki; Sasahira, Naoki; Feretis, Michael; Balakrishnan, Anita; Ceresa, Carlo; Davidson, Brian; Pande, Rupaly; Dasari, Bobby; Tanno, Lulu; Karavias, Dimitrios; Helliwell, Jack; Young, Alistair; Nunes, Quentin; Urbonas, Tomas; Silva, Michael; Gordon-Weeks, Alex; Barrie, Jenifer; Gomez, Dhanny; Van Laarhoven, Stijn; Robertson, Francis; Nawara, Hossain; Doyle, Joseph; Bhogal, Ricky; Harrison, Ewen; Roalso, Marcus; Ciprani, Debora; Aroori, Somaiah; Ratnayake, Bathiya; Koea, Jonathan; Capurso, Gabriele; Bellotti, Ruben; Stättner, Stefan; Alsaoudi, Tareq; Bhardwaj, Neil; Rajesh, Srujan; Jeffery, Fraser; Connor, Saxon; Cameron, Andrew; Jamieson, Nigel; Sheen, Amy; Mittal, Anubhav; Samra, Jas; Gill, Anthony.
Affiliation
  • Lucocq J; Department of General Surgery, NHS Lothian, Edinburgh, UK.
  • Hawkyard J; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
  • Haugk B; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
  • Mownah O; Department of Hepatobiliary and Pancreatic Surgery, King's College Hospital, London, UK.
  • Menon K; Department of Hepatobiliary and Pancreatic Surgery, King's College Hospital, London, UK.
  • Furukawa T; Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Inoue Y; Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Hirose Y; Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Sasahira N; Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
  • Feretis M; Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK.
  • Balakrishnan A; Cambridge Hepatobiliary and Pancreatic Surgery Unit, Addenbrooke's Hospital, Cambridge, UK.
  • Ceresa C; Hepatobiliary and Pancreatic Surgery Unit, Royal Free Hospital, London, UK.
  • Davidson B; Hepatobiliary and Pancreatic Surgery Unit, Royal Free Hospital, London, UK.
  • Pande R; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.
  • Dasari B; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.
  • Tanno L; Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK.
  • Karavias D; Hepatobiliary and Pancreatic Surgery Unit, University Hospital Southampton, Southampton, UK.
  • Helliwell J; Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Young A; Hepatobiliary and Pancreatic Surgery Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Nunes Q; Department of Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, Blackburn, UK.
  • Urbonas T; Oxford Hepato-Pancreato-Biliary Surgical Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Silva M; Oxford Hepato-Pancreato-Biliary Surgical Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Gordon-Weeks A; Oxford Hepato-Pancreato-Biliary Surgical Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Barrie J; Nottingham Hepato-Pancreatico-Biliary Service, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK.
  • Gomez D; Nottingham Hepato-Pancreatico-Biliary Service, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK.
  • Van Laarhoven S; Department of General Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
  • Robertson F; Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
  • Nawara H; Department of General Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
  • Doyle J; Gastrointestinal Unit, Royal Marsden NHS Foundation Trust, London, UK.
  • Bhogal R; Gastrointestinal Unit, Royal Marsden NHS Foundation Trust, London, UK.
  • Harrison E; Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK.
  • Roalso M; Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
  • Ciprani D; Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Aroori S; Hepatopancreatobiliary Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Ratnayake B; Hepato-pancreatico-biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, New Zealand.
  • Koea J; Hepato-pancreatico-biliary/Upper Gastrointestinal Unit, North Shore Hospital, Auckland, New Zealand.
  • Capurso G; Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy.
  • Bellotti R; Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.
  • Stättner S; Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.
  • Alsaoudi T; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
  • Bhardwaj N; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
  • Rajesh S; Leicester Hepatopancreatobiliary Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
  • Jeffery F; Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
  • Connor S; Department of General and Vascular Surgery, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
  • Cameron A; Wolfson Wohl Cancer Research Centre, Research Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
  • Jamieson N; Wolfson Wohl Cancer Research Centre, Research Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
  • Sheen A; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
  • Mittal A; Department of Hepatopancreatobiliary Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
  • Samra J; Department of Hepatopancreatobiliary Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
  • Gill A; New South Wales Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Br J Surg ; 111(4)2024 Apr 03.
Article de En | MEDLINE | ID: mdl-38659247
ABSTRACT

BACKGROUND:

The clinical impact of adjuvant chemotherapy after resection for adenocarcinoma arising from intraductal papillary mucinous neoplasia is unclear. The aim of this study was to identify factors related to receipt of adjuvant chemotherapy and its impact on recurrence and survival.

METHODS:

This was a multicentre retrospective study of patients undergoing pancreatic resection for adenocarcinoma arising from intraductal papillary mucinous neoplasia between January 2010 and December 2020 at 18 centres. Recurrence and survival outcomes for patients who did and did not receive adjuvant chemotherapy were compared using propensity score matching.

RESULTS:

Of 459 patients who underwent pancreatic resection, 275 (59.9%) received adjuvant chemotherapy (gemcitabine 51.3%, gemcitabine-capecitabine 21.8%, FOLFIRINOX 8.0%, other 18.9%). Median follow-up was 78 months. The overall recurrence rate was 45.5% and the median time to recurrence was 33 months. In univariable analysis in the matched cohort, adjuvant chemotherapy was not associated with reduced overall (P = 0.713), locoregional (P = 0.283) or systemic (P = 0.592) recurrence, disease-free survival (P = 0.284) or overall survival (P = 0.455). Adjuvant chemotherapy was not associated with reduced site-specific recurrence. In multivariable analysis, there was no association between adjuvant chemotherapy and overall recurrence (HR 0.89, 95% c.i. 0.57 to 1.40), disease-free survival (HR 0.86, 0.59 to 1.30) or overall survival (HR 0.77, 0.50 to 1.20). Adjuvant chemotherapy was not associated with reduced recurrence in any high-risk subgroup (for example, lymph node-positive, higher AJCC stage, poor differentiation). No particular chemotherapy regimen resulted in superior outcomes.

CONCLUSION:

Chemotherapy following resection of adenocarcinoma arising from intraductal papillary mucinous neoplasia does not appear to influence recurrence rates, recurrence patterns or survival.
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Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Pancréatectomie / Tumeurs du pancréas / Récidive tumorale locale Langue: En Journal: Br J Surg Année: 2024 Type de document: Article Pays d'affiliation: Royaume-Uni
Texte intégral
Ajouter à My VHL
Imprimer
XML
PubMed Links
Recherche sur Google

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Pancréatectomie / Tumeurs du pancréas / Récidive tumorale locale Langue: En Journal: Br J Surg Année: 2024 Type de document: Article Pays d'affiliation: Royaume-Uni