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Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer: An International Multicenter Cohort Study
E. van Veldhuisen, S. Klompmaker, QP. Janssen, MA. Hilal, A. Alseidi, A. Balduzzi, G. Balzano, C. Bassi, F. Berrevoet, M. Bonds, OR. Busch, G. Butturini, KC. Conlon, IM. Frigerio, GK. Fusai, J. Gagnière, O. Griffin, T. Hackert, A. Halimi, T....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu multicentrická studie, časopisecké články
NLK
Free Medical Journals
od 1994 do Před 24 měsíci
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2009-07-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- fluoruracil aplikace a dávkování terapeutické užití MeSH
- leukovorin aplikace a dávkování MeSH
- lidé MeSH
- nádory slinivky břišní * farmakoterapie patologie chirurgie MeSH
- neoadjuvantní terapie škodlivé účinky metody MeSH
- protokoly protinádorové kombinované chemoterapie * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
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.
Department of Gastroenterological Surgery Helsinki University Hospital Helsinki Finland
Department of General and HPB Surgery Gent University Hospital Gent Belgium
Department of General Surgery Hospital Universitario Marques de Valdecilla Santander Spain
Department of General Surgery Istituto Ospedaliero Fondazione Poliambulanza Brescia Italy
Department of Hepato Pancreato Biliary Surgery Oslo University Hospital Oslo Norway
Department of Medical Oncology Odense University Hospital Odense Denmark
Department of Radiology St Antonius Hospital Nieuwegein The Netherlands
Department of Surgery Erasmus MC University Medical Center Rotterdam The Netherlands
Department of Surgery Karolinska Institutet Stockholm Sweden
Department of Surgery Odense Pancreas Center Odense University Hospital Odense Denmark
Department of Surgery Pancreas Unit Ospedale San Raffaele Milan Italy
Department of Surgery Trinity College Dublin and St Vincent's University Hospital Dublin Ireland
Department of Surgery Universitaet zu Luebeck Luebeck Germany
Department of Surgery University Hospital Birmingham Birmingham UK
Department of Surgery University Hospital Southampton NHS Southampton UK
Department of Surgery University Medical Center Utrecht Utrecht The Netherlands
Department of Surgery University of California San Francisco USA
HPB Surgery and Liver Transplantation Unit Royal Free Hospital London UK
HPB Surgery Unit Pederzoli Hospital Peschiera del Garda Verona Italy
U1071 INSERM Clermont Auvergne University Clermont Ferrand France
Citace poskytuje Crossref.org
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- $a van Veldhuisen, Eran $u Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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- $a Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer: An International Multicenter Cohort Study / $c E. van Veldhuisen, S. Klompmaker, QP. Janssen, MA. Hilal, A. Alseidi, A. Balduzzi, G. Balzano, C. Bassi, F. Berrevoet, M. Bonds, OR. Busch, G. Butturini, KC. Conlon, IM. Frigerio, GK. Fusai, J. Gagnière, O. Griffin, T. Hackert, A. Halimi, T. Keck, J. Kleeff, U. Klaiber, KJ. Labori, M. Lesurtel, G. Malleo, MV. Marino, IQ. Molenaar, MB. Mortensen, A. Nikov, M. Pagnanelli, R. Pandé, P. Pfeiffer, D. Pietrasz, E. Rangelova, KJ. Roberts, AS. Cunha, R. Salvia, O. Strobel, T. Tarvainen, JW. Wilmink, BG. Koerkamp, MG. Besselink, Scientific Committee of the European-African Hepato-Pancreato-Biliary Association
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- $a 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.
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