Impact of conversion surgery on survival in locally advanced pancreatic cancer patients treated with FOLFIRINOX chemotherapy.

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Tytuł:: Impact of conversion surgery on survival in locally advanced pancreatic cancer patients treated with FOLFIRINOX chemotherapy.
Autorzy:: Lee M; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kang JS; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kim H; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kwon W; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Lee SH; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Ryu JK; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kim YT; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Oh DY; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Chie EK; Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jang JY; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Źródło:: Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2023 Jan; Vol. 30 (1), pp. 111-121. Date of Electronic Publication: 2021 Oct 06.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2014- : Tokyo : Wiley Japan
Original Publication: Tokyo : Springer Japan
MeSH Terms:: Antineoplastic Combined Chemotherapy Protocols*/therapeutic use
Pancreatic Neoplasms*/diagnostic imaging
Pancreatic Neoplasms*/drug therapy
Pancreatic Neoplasms*/surgery
Humans ; Fluorouracil/therapeutic use ; Irinotecan/therapeutic use ; Leucovorin/therapeutic use ; Neoadjuvant Therapy
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Contributed Indexing:: Keywords: carcinoma; neoadjuvant therapies; pancreatic ductal; survival
Substance Nomenclature:: U3P01618RT (Fluorouracil)
0 (folfirinox)
7673326042 (Irinotecan)
Q573I9DVLP (Leucovorin)
Entry Date(s):: Date Created: 20210928 Date Completed: 20230120 Latest Revision: 20230120
Update Code:: 20230123
DOI:: 10.1002/jhbp.1050
PMID:: 34581022
: Czasopismo naukowe

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Background: Locally advanced (unresectable) pancreatic cancer (LAPC) is surgically unresectable and often treated with chemotherapy. Most previous studies, that have evaluated conversion surgery after chemotherapy, included heterogeneous patients and chemotherapy regimens, making it challenging to determine the impact of FOLFIRINOX. The present study evaluated the survival benefit of conversion surgery in patients with LAPC who received FOLFIRINOX chemotherapy, and analyzed the prognostic factors.
Methods: Patients with LAPC who received FOLFIRINOX as first-line therapy for at least four cycles were included. During chemotherapy, surgical eligibility was determined based on radiologic and metabolic response to the treatment. Clinicopathologic characteristics were compared between the curative-intent surgery and non-resection groups, and the prognostic factors were analyzed.
Results: A total of 279 patients were included. The rates of partial response (PR) and stable disease (SD) were 34.1% and 51.4%, respectively, and 16.8% patients underwent curative-intent surgery. The median survival was significantly longer in the resection group than in the non-resection group (56 vs 21 months, P < .001). In a multivariate analysis, curative-intent surgery (HR 0.260; P < .001) was the most important factor.
Conclusions: Conversion surgery after FOLFIRINOX chemotherapy effectively rescues patients with LAPC. Patients without progression after FOLFIRINOX could be considered as potential candidates for conversion surgery.
(© 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

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