Outcomes of patients with initially unresectable pancreatic cancer who underwent conversion surgery after FOLFIRINOX or gemcitabine plus nab-paclitaxel chemotherapy: A multicenter retrospective cohort study (PC-CURE-1).

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Naohiro Okano, Manabu Kawai, Makoto Ueno, Xianjun Yu, Yosuke Inoue, Shinichiro Takahashi, Wenquan Wang, Hidenori Takahashi, Yukiyasu Okamura, Soichiro Morinaga, Ippei Matsumoto, Yasuhiro Shimizu, Kazuhiro Yoshida, Tomohisa Yamamoto, Masayuki Ohtsuka, Yoshikuni Inokawa, Satoshi Nara, Jun Tamura, Satoru Shinoda, Kouji Yamamoto, Hiroki Yamaue, Junji Furuse
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引用次数: 0

Abstract

Background: The efficacy and safety of conversion surgery (CS) after FOLFIRINOX or gemcitabine plus nab-paclitaxel (GnP) chemotherapy in patients with initially unresectable pancreatic cancer (PC) remains unclear.

Methods: This multicenter retrospective cohort study enrolled patients, between 2014 and 2018, with initially locally advanced or metastatic PC who were considered candidates for CS following FOLFIRINOX or GnP chemotherapy. They were classified into surgery (207 patients [194 resection and 13 exploratory laparotomy only]) and continued chemotherapy (10 patients, control) groups. The primary endpoint was overall survival (OS) from the day of diagnosis of potentially curative resection on imaging studies, with an expected hazard ratio (HR) of 0.7.

Results: OS in the surgery group was longer than that in the control group (HR, 0.47; 95% confidence interval [CI]: 0.24-0.93). The median OS was 34.4 (95% CI: 27.9-43.4) and 19.8 (95% CI: 14.9-31.1) months in the surgery and control groups, respectively. The Clavien-Dindo grade ≥ IIIa postoperative complication and in-hospital mortality rates were 19.6% and 0.5%, respectively. Multivariate analysis revealed that preoperative chemotherapy duration was not associated with OS.

Conclusions: CS, following a favorable response to FOLFIRINOX or GnP chemotherapy, improved initially unresectable PC prognosis (specifically, OS), regardless of the chemotherapy duration.

FOLFIRINOX 或吉西他滨加纳布紫杉醇化疗后接受转化手术的最初无法切除的胰腺癌患者的疗效:多中心回顾性队列研究(PC-CURE-1)。
背景:在FOLFIRINOX或吉西他滨+纳布-紫杉醇(GnP)化疗后,最初无法切除的胰腺癌(PC)患者接受转换手术(CS)的疗效和安全性仍不明确:这项多中心回顾性队列研究招募了2014年至2018年期间的初诊局部晚期或转移性PC患者,这些患者被认为是FOLFIRINOX或GnP化疗后CS的候选者。他们被分为手术组(207 例患者[194 例切除术和 13 例探查性开腹手术])和继续化疗组(10 例患者,对照组)。主要终点是自影像学检查诊断为潜在根治性切除术之日起的总生存期(OS),预期危险比(HR)为 0.7:手术组的 OS 长于对照组(HR,0.47;95% 置信区间 [CI]:0.24-0.93)。手术组和对照组的中位OS分别为34.4个月(95% CI:27.9-43.4)和19.8个月(95% CI:14.9-31.1)。Clavien-Dindo ≥ IIIa 级术后并发症和院内死亡率分别为 19.6% 和 0.5%。多变量分析显示,术前化疗时间与OS无关:结论:无论化疗持续时间长短如何,在对FOLFIRINOX或GnP化疗产生良好反应后进行CS治疗,可改善初始不可切除PC的预后(尤其是OS)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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