The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study: an international multicenter study
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| Název: | The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study: an international multicenter study |
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| Autoři: | Rangelova, E., Stoop, T.F., van Ramshorst, T.M.E., Ali, M., van Bodegraven, E.A., Javed, A.A., Hashimoto, D., Steyerberg, E., Banerjee, A., Jain, A., Sauvanet, A., Serrablo, A., Giani, A., Giardino, A., Zerbi, A., Arshad, A., Wijma, A.G., Coratti, A., Zironda, A., Socratous, A., Rojas, A., Halimi, A., Ejaz, A., Oba, A., Patel, B.Y., Björnsson, B., Reames, B.N., Tingstedt, B., Goh, B.K.P., Payá-Llorente, C., Domingo del Pozo, C., González-Abós, C., Medin, C., van Eijck, C.H.J., de Ponthaud, Charles, Takishita, C., Schwabl, C., Månsson, C., Ricci, C., Thiels, C.A., Douchi, D., Hughes, D.L., Kilburn, D., Flanking, D., Kleive, D., Sousa Silva, D., Edil, B.H., Pando, E., Moltzer, E., Kauffman, E.F., Warren, E., Bozkurt, E., Sparrelid, E., Thoma, E., Verkolf, E., Ausania, F., Giannone, F., Hüttner, F.J., Burdio, F., Souche, F.R., Berrevoet, F., Daams, F., Motoi, F., Saliba, G., Kazemier, G., Roeyen, G., Nappo, G., Butturini, G., Ferrari, G., Kito Fusai, G., Honda, G., Sergeant, G., Karteszi, H., Takami, H., Suto, H., Matsumoto, I., Mora-Oliver, I., Frigerio, I., Fabre, J.M., Chen, J., Sham, J.G., Davide, J., Urdzik, J., de Martino, J., Nielsen, K., Okano, K., Kamei, K., Okada, K., Tanaka, K., Labori, K.J., Goodsell, K.E., Alberici, L., Webber, L., Kirkov, L., de Franco, L., Miyashita, M., Maglione, M., Gramellini, M., Ramera, M., João Amaral, M., Ramaekers, M., Truty, M.J., van Dam, M.A., Stommel, M.W.J., Petrikowski, M., Imamura, M., Hayashi, M., D’hondt, M., Brunner, M., Hogg, M.E., Zhang, C., Ángel Suárez-Muñoz, M., Luyer, M.D., Unno, M., Mizuma, M., Janot, M., Sahakyan, M.A., Jamieson, N.B., Busch, O.R., Bilge, O., Belyaev, O., Franklin, O., Sánchez-Velázquez, P., Pessaux, P., Strandberg Holka, P., Ghorbani, P., Casadei, R., Sartoris, R., Schulick, R.D., Grützmann, R., Sutcliffe, R., Mata, R., Patel, R.B., Takahashi, R., Rodriguez Franco, S., Sánchez Cabús, S., Hirano, S., Gaujoux, S., Festen, S., Kozono, S., Maithel, S.K., Chai, S.M., Yamaki, S., van Laarhoven, S., Mieog, J.S.D., Murakami, T., Codjia, T., Sumiyoshi, T., Karsten, T.M., Nakamura, T., Sugawara, T., Boggi, U., Hartman, V., de Meijer, V.E., Bartholomä, W., Kwon, W., Koh, Y.X., Cho, Y., Takeyama, Y., Inoue, Y., Nagakawa, Y., Kawamoto, Y., Ome, Y., Soonawalla, Z., Uemura, K., Wolfgang, C.L., Jang, J.Y., Padbury, R., Satoi, S., Messersmith, W., Wilmink, J.W., Abu Hilal, M., Besselink, M.G., del Chiaro, M., Michalski, C.W., Ishida, H., Dennahy, I.S., Carter, J.A., Schnuck Olapo, J., Caldera, M., Mazzola, M., Oshima, Minoru, Tanaka, N., de Wilde, R.F., Hoon Choi, S., Sato, S., Sugawara, S., Abadia-Forcen, T., Pawlik, T.M., Tufekci, T., Kimura, Y. |
| Přispěvatelé: | Institut Català de la Salut, [Rangelova E] Department of Upper Abdominal Surgery at Sahlgrenska University Hospital, Gothenburg, Sweden. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. [Stoop TF] Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA. [van Ramshorst TME] Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. Department of Surgery, Fondazione Poliambulanza, Instituto Ospedaliero, Brescia, Italy. [Ali M] Cancer Center Amsterdam, Amsterdam, The Netherlands. Amsterdam UMC, Location Vrije Universiteit, Department of Surgery, Amsterdam, The Netherlands. [van Bodegraven EA] Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. [Javed AA] Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands. Cancer Center Amsterdam, Amsterdam, The Netherlands. Department of Surgical Oncology, Department of Surgery, New York University Medical Center, New York, USA. [Pando E, Mata R] Universitat Autònoma de Barcelona, Barcelona, Spain. Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, de ponthaud, charles, European Consortium on Minimally Invasive Pancreatic Surgery, International Consortium on Advanced Pancreatic Surgery, SUAREZ MUNOZ, MIGUEL ANGEL/0000-0001-9012-8670, Labori, Knut, Jorgen/0000-0001-6777-7955, Hashimoto, Daisuke/0000-0002-7880-889X, Ali, Mahsoem/0000-0002-0511-6323, Stoop, Thomas F./0000-0003-3328-4516, Domingo Del Pozo, Carlos/0000-0003-4499-3019, Petrikowski, Marvin/0009-0000-8665-0925, Tufekci, Tutku/0000-0001-9083-2158, Sanchez-Velazquez, Patricia/0000-0002-7902-3920, Wijma, Allard, Geert/0000-0003-4227-4715, Javed, Ammar/0000-0002-5463-5250, Pando, Elizabeth/0000-0001-6898-5502, Rangelova, E., Stoop, T. F., van Ramshorst, T. M. E., Ali, M., van Bodegraven, E. A., Javed , A. A., Hashimoto, D., Steyerberg, E., Banerjee, A., Jain, A., Sauvanet, A., Serrablo, A., Giani, A., Giardino, A., Zerbi, A., Arshad, A., Wijma, A. G., Coratti, A., Zironda, A., Socratous, A., Rojas, A., Halimi, A., Ejaz, A., Oba, A., Patel, B. Y., Bjornsson, B., Reames, B. N., Tingstedt, B., Goh, B. K. P., Paya-Llorente, C., Del Pozo, C. D., Gonzalez-Abos, C., Medin, C., van Eijck, C. H. J., de Ponthaud, C., Takishita, C., Schwabl, C., Mansson, C., Ricci, C., Thiels, C. A., Douchi, D., Hughes, D. L., Kilburn, D., Flanking, D., Kleive, D., Silva, D. S., Edil, B. H., Pando, E., Moltzer, E., Kauffman, E. F., Warren, E., Bozkurt, E., Sparrelid, E., Thoma, E., Verkolf, E., Ausania, F., Giannone, F., Huttner, F. J., Burdio, F., Souche, F. R., Berrevoet, F., Daams, F., Motoi, F., Saliba, G., Kazemier, G., Roeyen, G., Nappo, G., Butturini, G., Ferrari, G., Fusai, G. Kito, Honda, G., SERGEANT, Gregory, Karteszi, H., Takami, H., Suto, H., Matsumoto, I., Mora-Oliver, I., Frigerio, I., Fabre, J. M., Chen, J., Sham, J. G., Davide, J., Urdzik, J., de Martino, J., Nielsen, K., Okano, K., Kamei, K., Okada, K., Tanaka, K., Labori, K. J., Goodsell, K. E., Alberici, L., Webber, L., Kirkov, L., de Franco, L., Miyashita, M., Maglione, M., Gramellini, M., Ramera, M., Amaral, M. J., Ramaekers, M., Truty, M. J., van Dam, M. A., Stommel, M. W. J., Petrikowski, M., Imamura, M., Hayashi, M., D'Hondt, M., Brunner, M., Hogg, M. E., Zhang, C., Suarez-Munoz, M. A., Luyer, M. D., Unno, M., Mizuma, M., Janot, M., Sahakyan, M. A., Jamieson, N. B., Busch, O. R., Bilge, O., Belyaev, O., Franklin, O., Sanchez-Velazquez, P., Pessaux, P., Holka, P. S., Ghorbani, P., Casadei, R., Sartoris, R., Schulick, R. D., Grutzmann, R., Sutcliffe, R., Mata, R., Patel, R. B., Takahashi, R., Franco, S. Rodriguez, Cabus, S. S., Hirano, S., Gaujoux, S., Festen, S., Kozono, S., Maithel, S. K., Chai, S. M., Yamaki, S., van Laarhoven, S., Mieog, J. S. D., Murakami, T., Codjia, T., Sumiyoshi, T., Karsten, T. M., Nakamura, T., Sugawara, T., Boggi, U., Hartman, V., de Meijer, V. E., Bartholoma, W., Kwon, W., Koh, Y. X., Cho, Y., Takeyama, Y., Inoue, Y., Nagakawa, Y., Kawamoto, Y., Ome, Y., Soonawalla, Z., Uemura, K., Wolfgang, C. L., Jang, J. Y., Padbury, R., Satoi, S., Messersmith, W., Wilmink, J. W., Abu Hilal, M., Besselink, M. G., Del Chiaro, M. |
| Zdroj: | ANNALS OF ONCOLOGY r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname Scientia Scientia. Dipòsit d'Informació Digital del Departament de Salut r-FISABIO. Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) Annals of Oncology, 36, 5, pp. 529-542 Annals of oncology |
| Informace o vydavateli: | Elsevier BV, 2025. |
| Rok vydání: | 2025 |
| Témata: | ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas, Other subheadings::Other subheadings::/therapy, Resectable, splenic vein, Pàncrees - Càncer - Cirurgia, Gastroenterology and Hepatology, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Digestive System Surgical Procedures::Pancreatectomy, CA19.9, DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Combined Modality Therapy::Neoadjuvant Therapy, splenic artery, SDG 3 - Good Health and Well-being, Pàncrees - Càncer - Tractament, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento combinado::tratamiento neoadyuvante, pancreatic adenocarcinoma, neoadjuvant therapy, Pancreatic body/tail, Cancer och onkologi, pancreatic body/tail, Kirurgi, tumor size, multivisceral involvement, Tumor size, CA19-9, resectable, Otros calificadores::Otros calificadores::/terapia, Cancer and Oncology, Neoadjuvant therapy, Surgery, Human medicine, [SHS] Humanities and Social Sciences, Gastroenterologi och hepatologi, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::pancreatectomía, Pancreatic adenocarcinoma, Surgery - Radboud University Medical Center |
| Popis: | Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients with right-sided RPC. The purpose of this study was to assess the association between neoadjuvant therapy and OS in patients with left-sided RPC compared with upfront surgery.This was an international multicenter retrospective study including consecutive patients after left-sided pancreatic resection for pathology-proven RPC, either after neoadjuvant therapy or upfront surgery in 76 centers from 18 countries on 4 continents (2013-2019). The primary endpoint was OS from diagnosis. Time-dependent Cox regression analysis was carried out to investigate the association of neoadjuvant therapy with OS, adjusting for confounders at the time of diagnosis. Adjusted OS probabilities were calculated.Overall, 2282 patients after left-sided pancreatic resection for RPC were included of whom 290 patients (13%) received neoadjuvant therapy. The most common neoadjuvant regimens were (m)FOLFIRINOX (38%) and gemcitabine-nab-paclitaxel (22%). After upfront surgery, 72% of patients received adjuvant chemotherapy, mostly a single-agent regimen (74%). Neoadjuvant therapy was associated with prolonged OS compared with upfront surgery (adjusted hazard ratio 0.69, 95% confidence interval 0.58-0.83) with an adjusted median OS of 53 versus 37 months (P = 0.0003) and adjusted 5-year OS rates of 47% versus 35% (P = 0.0001) compared with upfront surgery. Interaction analysis demonstrated a stronger effect of neoadjuvant therapy in patients with a larger tumor (Pinteraction = 0.003) and higher serum carbohydrate antigen 19-9 (CA19-9; Pinteraction = 0.005). In contrast, the effect of neoadjuvant therapy was not enhanced for splenic artery (Pinteraction = 0.43), splenic vein (Pinteraction = 0.30), retroperitoneal (Pinteraction = 0.84), and multivisceral (Pinteraction = 0.96) involvement.Neoadjuvant therapy in patients with left-sided RPC was associated with improved OS compared with upfront surgery. The impact of neoadjuvant therapy increased with larger tumor size and higher serum CA19-9 at diagnosis. Randomized controlled trials on neoadjuvant therapy specifically in patients with left-sided RPC are needed. |
| Druh dokumentu: | Article |
| Popis souboru: | application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Jazyk: | English |
| ISSN: | 0923-7534 |
| DOI: | 10.1016/j.annonc.2024.12.015 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/39814200 https://incliva.fundanetsuite.com/publicaciones/ProdCientif/PublicacionFrw.aspx?id=20058 http://hdl.handle.net/11351/13279 https://fisabio.portalinvestigacion.com/publicaciones/18318 https://pure.eur.nl/en/publications/85b2dcbb-ceec-4047-a673-48317d4ab4ee https://doi.org/10.1016/j.annonc.2024.12.015 https://hdl.handle.net/2066/319068 https://repository.ubn.ru.nl//bitstream/handle/2066/319068/319068.pdf https://repository.uantwerpen.be/docstore/d:irua:28279 https://hdl.handle.net/10067/2135500151162165141 https://hdl.handle.net/11585/1008290 https://doi.org/10.1016/j.annonc.2024.12.015 https://www.sciencedirect.com/science/article/pii/S0923753425000043 http://hdl.handle.net/1942/46365 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-235850 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-562266 |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....b828048a704796032c24dbcce7b45208 |
| Databáze: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstrakt: | Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients with right-sided RPC. The purpose of this study was to assess the association between neoadjuvant therapy and OS in patients with left-sided RPC compared with upfront surgery.This was an international multicenter retrospective study including consecutive patients after left-sided pancreatic resection for pathology-proven RPC, either after neoadjuvant therapy or upfront surgery in 76 centers from 18 countries on 4 continents (2013-2019). The primary endpoint was OS from diagnosis. Time-dependent Cox regression analysis was carried out to investigate the association of neoadjuvant therapy with OS, adjusting for confounders at the time of diagnosis. Adjusted OS probabilities were calculated.Overall, 2282 patients after left-sided pancreatic resection for RPC were included of whom 290 patients (13%) received neoadjuvant therapy. The most common neoadjuvant regimens were (m)FOLFIRINOX (38%) and gemcitabine-nab-paclitaxel (22%). After upfront surgery, 72% of patients received adjuvant chemotherapy, mostly a single-agent regimen (74%). Neoadjuvant therapy was associated with prolonged OS compared with upfront surgery (adjusted hazard ratio 0.69, 95% confidence interval 0.58-0.83) with an adjusted median OS of 53 versus 37 months (P = 0.0003) and adjusted 5-year OS rates of 47% versus 35% (P = 0.0001) compared with upfront surgery. Interaction analysis demonstrated a stronger effect of neoadjuvant therapy in patients with a larger tumor (Pinteraction = 0.003) and higher serum carbohydrate antigen 19-9 (CA19-9; Pinteraction = 0.005). In contrast, the effect of neoadjuvant therapy was not enhanced for splenic artery (Pinteraction = 0.43), splenic vein (Pinteraction = 0.30), retroperitoneal (Pinteraction = 0.84), and multivisceral (Pinteraction = 0.96) involvement.Neoadjuvant therapy in patients with left-sided RPC was associated with improved OS compared with upfront surgery. The impact of neoadjuvant therapy increased with larger tumor size and higher serum CA19-9 at diagnosis. Randomized controlled trials on neoadjuvant therapy specifically in patients with left-sided RPC are needed. |
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| ISSN: | 09237534 |
| DOI: | 10.1016/j.annonc.2024.12.015 |