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Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer: An International Multicenter Cohort Study.
van Veldhuisen, Eran; Klompmaker, Sjors; Janssen, Quisette P; Hilal, Mohammed Abu; Alseidi, Adnan; Balduzzi, Alberto; Balzano, Gianpaolo; Bassi, Claudio; Berrevoet, Frederik; Bonds, Morgan; Busch, Olivier R; Butturini, Giovanni; Conlon, Kevin C; Frigerio, Isabella M; Fusai, Giuseppe K; Gagnière, Johan; Griffin, Oonagh; Hackert, Thilo; Halimi, Asif; Keck, Tobias; Kleeff, Jörg; Klaiber, Ulla; Labori, Knut J; Lesurtel, Mickael; Malleo, Giuseppe; Marino, Marco V; Molenaar, I Quintus; Mortensen, Michael B; Nikov, Andrej; Pagnanelli, Michele; Pandé, Rupaly; Pfeiffer, Per; Pietrasz, Daniel; Rangelova, Elena; Roberts, Keith J; Cunha, Antonio Sa; Salvia, Roberto; Strobel, Oliver; Tarvainen, Timo; Wilmink, Johanna W; Koerkamp, Bas Groot; Besselink, Marc G.
Afiliação
  • van Veldhuisen E; Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
  • Klompmaker S; Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
  • Janssen QP; Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Hilal MA; Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
  • Alseidi A; Department of Surgery, University Hospital Southampton NHS, Southampton, UK.
  • Balduzzi A; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
  • Balzano G; Department of Surgery, University of California, San Francisco, USA.
  • Bassi C; Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
  • Berrevoet F; Department of Surgery, Pancreas Unit, Ospedale San Raffaele, Milan, Italy.
  • Bonds M; Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
  • Busch OR; Department of General and HPB Surgery, Gent University Hospital, Gent, Belgium.
  • Butturini G; Department of Surgery, University of California, San Francisco, USA.
  • Conlon KC; Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
  • Frigerio IM; HPB Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
  • Fusai GK; Department of Surgery, Trinity College Dublin and St. Vincent's University Hospital, Dublin, Ireland.
  • Gagnière J; HPB Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
  • Griffin O; HPB Surgery and Liver Transplantation Unit, Royal Free Hospital, London, UK.
  • Hackert T; U1071 INSERM, Clermont-Auvergne University, Clermont-Ferrand, France.
  • Halimi A; Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Keck T; Department of Surgery, Trinity College Dublin and St. Vincent's University Hospital, Dublin, Ireland.
  • Kleeff J; Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Klaiber U; Department of Surgery, Karolinska Institutet, Stockholm, Sweden.
  • Labori KJ; Department of Surgery, Universitaet zu Luebeck, Luebeck, Germany.
  • Lesurtel M; Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany.
  • Malleo G; Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Heidelberg, Heidelberg, Germany.
  • Marino MV; Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.
  • Molenaar IQ; Department of Surgery and Liver Transplantation, Croix Rousse University Hospital, University of Lyon, Hospices Civils de LyonLyon, France.
  • Mortensen MB; Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
  • Nikov A; Department of General Surgery, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Pagnanelli M; Department of General Surgery, Hospital Universitario Marques de Valdecilla, Santander, Spain.
  • Pandé R; Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Pfeiffer P; Department of Surgery, Odense Pancreas Center (OPAC), Odense University Hospital, Odense, Denmark.
  • Pietrasz D; Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
  • Rangelova E; Department of Surgery, Pancreas Unit, Ospedale San Raffaele, Milan, Italy.
  • Roberts KJ; Department of Surgery, University Hospital Birmingham, Birmingham, UK.
  • Cunha AS; Department of Medical Oncology, Odense University Hospital, Odense, Denmark.
  • Salvia R; Department of Hepato-Biliary-Pancreatic Surgery, Liver Transplant Center, Paul Brousse Hospital, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
  • Strobel O; Department of Surgery, Karolinska Institutet, Stockholm, Sweden.
  • Tarvainen T; Department of Surgery, University Hospital Birmingham, Birmingham, UK.
  • Wilmink JW; Department of Hepato-Biliary-Pancreatic Surgery, Liver Transplant Center, Paul Brousse Hospital, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
  • Koerkamp BG; Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
  • Besselink MG; Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Ann Surg Oncol ; 30(3): 1463-1473, 2023 Mar.
Article em En | MEDLINE | ID: mdl-36539580
BACKGROUND: Preoperative FOLFIRINOX chemotherapy is increasingly administered to patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) to improve overall survival (OS). Multicenter studies reporting on the impact from the number of preoperative cycles and the use of adjuvant chemotherapy in relation to outcomes in this setting are lacking. This study aimed to assess the outcome of pancreatectomy after preoperative FOLFIRINOX, including predictors of OS. METHODS: This international multicenter retrospective cohort study included patients from 31 centers in 19 European countries and the United States undergoing pancreatectomy after preoperative FOLFIRINOX chemotherapy (2012-2016). The primary end point was OS from diagnosis. Survival was assessed using Kaplan-Meier analysis and Cox regression. RESULTS: The study included 423 patients who underwent pancreatectomy after a median of six (IQR 5-8) preoperative cycles of FOLFIRINOX. Postoperative major morbidity occurred for 88 (20.8%) patients and 90-day mortality for 12 (2.8%) patients. An R0 resection was achieved for 243 (57.4%) patients, and 259 (61.2%) patients received adjuvant chemotherapy. The median OS was 38 months (95% confidence interval [CI] 34-42 months) for BRPC and 33 months (95% CI 27-45 months) for LAPC. Overall survival was significantly associated with R0 resection (hazard ratio [HR] 1.63; 95% CI 1.20-2.20) and tumor differentiation (HR 1.43; 95% CI 1.08-1.91). Neither the number of preoperative chemotherapy cycles nor the use adjuvant chemotherapy was associated with OS. CONCLUSIONS: This international multicenter study found that pancreatectomy after FOLFIRINOX chemotherapy is associated with favorable outcomes for patients with BRPC and those with LAPC. Future studies should confirm that the number of neoadjuvant cycles and the use adjuvant chemotherapy have no relation to OS after resection.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article