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Patterns of Recurre...
Patterns of Recurrence After Resection of Pancreatic Ductal Adenocarcinoma : A Secondary Analysis of the ESPAC-4 Randomized Adjuvant Chemotherapy Trial
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- Jones, Robert P. (författare)
- Royal Liverpool Univ Hosp, Liverpool, Merseyside, England
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- Psarelli, Eftychia-Eirini (författare)
- Univ Liverpool, Liverpool, Merseyside, England
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- Jackson, Richard (författare)
- Univ Liverpool, Liverpool, Merseyside, England
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visa fler...
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- Ghaneh, Paula (författare)
- Royal Liverpool Univ Hosp, Liverpool, Merseyside, England;Univ Liverpool, Liverpool, Merseyside, England
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- Halloran, Christopher M. (författare)
- Royal Liverpool Univ Hosp, Liverpool, Merseyside, England;Univ Liverpool, Liverpool, Merseyside, England
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- Palmer, Daniel H. (författare)
- Univ Liverpool, Liverpool, Merseyside, England;Clatterbridge Canc Ctr, Wirral, Merseyside, England
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- Campbell, Fiona (författare)
- Royal Liverpool Univ Hosp, Liverpool, Merseyside, England
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- Valle, Juan W. (författare)
- Univ Manchester Christie, Manchester, Lancs, England
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- Faluyi, Olusola (författare)
- Clatterbridge Canc Ctr, Wirral, Merseyside, England
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- O'Reilly, Derek A. (författare)
- Manchester Univ Fdn Trust, Manchester, Lancs, England
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- Cunningham, David (författare)
- Royal Marsden Hosp, London, England
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- Wadsley, Jonathan (författare)
- Weston Pk Hosp, Sheffield, S Yorkshire, England
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- Darby, Suzanne (författare)
- Weston Pk Hosp, Sheffield, S Yorkshire, England
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- Meyer, Tim (författare)
- Royal Free Hosp, London, England
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- Gillmore, Roopinder (författare)
- Royal Free Hosp, London, England
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- Anthoney, Alan (författare)
- St James Univ Hosp, Leeds, W Yorkshire, England
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- Lind, Pehr (författare)
- Karolinska Institutet
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- Glimelius, Bengt (författare)
- Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)
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- Falk, Stephen (författare)
- Bristol Haematol & Oncol Ctr, Bristol, Avon, England
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- Izbicki, Jakob R. (författare)
- Univ Hamburg, Med Inst UKE, Hamburg, Germany
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- Middleton, Gary William (författare)
- Royal Surrey Cty Hosp, Guildford, Surrey, England
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- Cummins, Sebastian (författare)
- Royal Surrey Cty Hosp, Guildford, Surrey, England
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- Ross, Paul J. (författare)
- Guys Hosp, London, England
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- Wasan, Harpreet (författare)
- Hammersmith Hosp, London, England
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- McDonald, Alec (författare)
- Beatson West Scotland Canc Ctr, Glasgow, Lanark, Scotland
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- Crosby, Tom (författare)
- Velindre Hosp, Cardiff, S Glam, Wales
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- Ting, Yuk (författare)
- Queen Elizabeth Hosp, Birmingham, W Midlands, England
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- Patel, Kinnari (författare)
- Churchill Hosp, Oxford, England
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- Sherriff, David (författare)
- Derriford Hosp, Plymouth, Devon, England
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- Soomal, Rubin (författare)
- Jersey Gen Hosp, Jersey, England
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- Borg, David (författare)
- Skane Univ Hosp, Lund, Sweden;Skane Univ Hosp, Malmo, Sweden
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- Sothi, Sharmila (författare)
- Univ Hosp Coventry, Coventry, W Midlands, England
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- Hammel, Pascal (författare)
- Hop Beaujon, Clichy, France
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- Lerch, Markus M. (författare)
- Greifswald Univ, Med, Greifswald, Germany
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- Mayerle, Julia (författare)
- Greifswald Univ, Med, Greifswald, Germany;Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Munich, Germany
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- Tjaden, Christine (författare)
- Heidelberg Univ, Heidelberg, Germany
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- Strobel, Oliver (författare)
- Heidelberg Univ, Heidelberg, Germany
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- Hackert, Thilo (författare)
- Heidelberg Univ, Heidelberg, Germany
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- Buchler, Markus W. (författare)
- Heidelberg Univ, Heidelberg, Germany
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- Neoptolemos, John P. (författare)
- Heidelberg Univ, Heidelberg, Germany
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- Hill, Mark (författare)
- Kent Oncol Ctr, Maidstone, Kent, England
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- Corrie, Pippa (författare)
- Addenbrookes Hosp, Cambridge, England
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- Hickish, Tamas (författare)
- Royal Bournemouth Hosp, Bournemouth, Dorset, England
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- Napier, Mark (författare)
- North Devon Dist Hosp Barnstaple, Barnstaple, England
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- Slater, Sarah (författare)
- St Bartholomews Hosp, London, England
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- Valle, Juan (författare)
- North Manchester Gen Hosp, Manchester, Lancs, England
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- Shablak, Alaaeldin (författare)
- Salisbury Dist Hosp, Salisbury, Wilts, England
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- Cunnell, Michelle (författare)
- Nottingham City Hosp, Nottingham, England
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- Guimbaud, Rosine (författare)
- CHU Purpan, Toulouse, France
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- Roques, Tom (författare)
- Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England
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- Iveson, Tim (författare)
- Southampton Gen Hosp, Southampton, Hants, England
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- Jamil, Arshad (författare)
- Univ Hosp North Staffordshire, Stoke, England;Leighton Hosp, Crewe, England
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- Robinson, Angus (författare)
- Conquest Hosp, Hastings, England
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- Garcia-Alonso, Angel (författare)
- Glan Clwyd Gen Hosp, Rhyl, Wales
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- Chang, David (författare)
- Royal Blackburn Hosp, Blackburn, Lancs, England
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- Tsang, David (författare)
- Southend Hosp, Westcliff On Sea, England
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- Wadd, Nick (författare)
- James Cook Univ Hosp, Middlesbrough, Cleveland, England
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- Wall, Lucy (författare)
- Western Gen Hosp, Edinburgh, Midlothian, Scotland
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- Nielsen, Niels Hilmer (författare)
- Norrlands Univ Sjukhus, Umea, Sweden
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- Lerch, Markus (författare)
- Ernst Moritz Arndt Univ Greifswald, Greifswald, Germany
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- Mehta, Ajay (författare)
- Royal Preston Hosp, Preston, Lancs, England
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- Sivaramalingam, Muthiah (författare)
- Blackpool Victoria Hosp, Blackpool, England
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- Fyfe, David (författare)
- Royal Lancaster Infirm, Lancaster, England
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- Osborne, Richard (författare)
- Poole Hosp, Poole, Dorset, England
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- Blesing, Claire (författare)
- Great Western Hosp, Swindon, Wilts, England
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- Bulusu, Venkata Ramesh (författare)
- Bedford Hosp, Bedford, England
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- Rathbone, Emma (författare)
- Huddersfield Royal Infirm, Huddersfield, W Yorkshire, England
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- Seitz, Jean-Francois (författare)
- CHU La Timone, Marseille, France
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- Beaumont, Erica (författare)
- Yeovil Dist Hosp, Yeovil, England
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- Dernedde, Ulrike (författare)
- James Paget Hosp, Great Yarmouth, England
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- McAdam, Karen (författare)
- Peterborough City Hosp, Peterborough, Cambs, England
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- Dimopoulos, Prokopios (författare)
- St Marys Hosp, Newport, Wight, England
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- Cominos, Mathilda (författare)
- Queen Elizabeth Queen Mother Hosp, Margate, England;William Harvey Hosp, Ashford, Kent, England
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- Askill, Colin (författare)
- Singleton Hosp, Swansea, England
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- Piwowar, Andrzej (författare)
- Vastmanlands Sjukhus, Vasteras, Sweden
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- Bachet, Jean-Baptiste (författare)
- Grp Hosp Pitie Salpetriere, Paris, France
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- Sumpter, Kate (författare)
- Freeman Rd Hosp, Newcastle, England
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- Raouf, Sherif (författare)
- Queens Hosp, Romford, Essex, England
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- Nicoll, Jonathan (författare)
- Cumberland Infirm, Carlisle, England
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- Rees, Charlotte (författare)
- Basingstoke & North Hampshire Hosp, Basingstoke, Hants, England
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- Dhinakaran, Kathirvelu (författare)
- Royal Shrewsbury Hosp, Shrewsbury, Salop, England
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- Haux, Johan (författare)
- Univ Sjukhuset Linkoping, Linkoping, Sweden
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- Bengrine-Lefevre, Leila (författare)
- Hop St Antoine, Paris, France
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- Terrebonne, Eric (författare)
- Hop Haut Leveque, Pessac, France
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- Shankland, Catherine (författare)
- Royal Derby Hosp, Derby, England
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- Palmer, Cheryl (författare)
- Hinchingbrooke Hosp, Huntingdon, England
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- Medley, Louise (författare)
- Torbay Hosp, Torquay, England
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- Toy, Elizabeth (författare)
- Royal Devon & Exeter Hosp, Exeter, Devon, England
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- Kaur, Jasvinder (författare)
- Darent Valley Hosp, Dartford, England
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- Gupta, Kamalnayan (författare)
- Alexandra Hosp, Redditch, England
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- Cheeseman, Sue (författare)
- Bradford Royal Infirm, Bradford, W Yorkshire, England
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- Patterson, Daniel (författare)
- West Suffolk Hosp, Bury St Edmunds, Suffolk, England
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- Candish, Charles (författare)
- Cheltenham Gen Hosp, Cheltenham, Glos, England
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- Thompson, Joyce (författare)
- Heartlands Hosp, Birmingham, W Midlands, England
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- Coxon, Fareeda (författare)
- Bishop Auckland Gen Hosp, Bishop Auckland, England;Darlington Mem Hosp, Darlington, Durham, England
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- Connolly, Caroline (författare)
- Stafford Hosp, Stafford, England
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- McPhail, Neil (författare)
- Raigmore Hosp, Inverness, Scotland
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- Williams, Rachel (författare)
- Ysbyty Gwynedd, Bangor, Gwynedd, Wales
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- Flygare, Petra (författare)
- Lanssjukhuset Sundsvall, Sundsvall, Sweden
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- Elmlund, Mattias (författare)
- Cent Sjukhuset Karlstad, Karlstad, Sweden
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- Artru, Pascal (författare)
- Hop Prive Jean Mermoz, Lyon, France
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- Millat, Bertrand (författare)
- Hop St Eloi, Montpellier, France
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(creator_code:org_t)
- AMER MEDICAL ASSOC, 2019
- 2019
- Engelska.
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Ingår i: JAMA Surgery. - : AMER MEDICAL ASSOC. - 2168-6254 .- 2168-6262. ; 154:11, s. 1038-1048
- Relaterad länk:
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https://jamanetwork....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Importance: The patterns of disease recurrence after resection of pancreatic ductal adenocarcinoma with adjuvant chemotherapy remain unclear.Objective: To define patterns of recurrence after adjuvant chemotherapy and the association with survival.Design, Setting, and Participants: Prospectively collected data from the phase 3 European Study Group for Pancreatic Cancer 4 adjuvant clinical trial, an international multicenter study. The study included 730 patients who had resection and adjuvant chemotherapy for pancreatic cancer. Data were analyzed between July 2017 and May 2019.Interventions: Randomization to adjuvant gemcitabine or gemcitabine plus capecitabine.Main Outcomes and Measures: Overall survival, recurrence, and sites of recurrence.Results: Of the 730 patients, median age was 65 years (range 37-81 years), 414 were men (57%), and 316 were women (43%). The median follow-up time from randomization was 43.2 months (95% CI, 39.7-45.5 months), with overall survival from time of surgery of 27.9 months (95% CI, 24.8-29.9 months) with gemcitabine and 30.2 months (95% CI, 25.8-33.5 months) with the combination (HR, 0.81; 95% CI, 0.68-0.98; P=.03). The 5-year survival estimates were 17.1% (95% CI, 11.6%-23.5%) and 28.0% (22.0%-34.3%), respectively. Recurrence occurred in 479 patients (65.6%); another 78 patients (10.7%) died without recurrence. Local recurrence occurred at a median of 11.63 months (95% CI, 10.05-12.19 months), significantly different from those with distant recurrence with a median of 9.49 months (95% CI, 8.44-10.71 months) (HR, 1.21; 95% CI, 1.01-1.45; P=.04). Following recurrence, the median survival was 9.36 months (95% CI, 8.08-10.48 months) for local recurrence and 8.94 months (95% CI, 7.82-11.17 months) with distant recurrence (HR, 0.89; 95% CI, 0.73-1.09; P=.27). The median overall survival of patients with distant-only recurrence (23.03 months; 95% CI, 19.55-25.85 months) or local with distant recurrence (23.82 months; 95% CI, 17.48-28.32 months) was not significantly different from those with only local recurrence (24.83 months; 95% CI, 22.96-27.63 months) (P=.85 and P=.35, respectively). Gemcitabine plus capecitabine had a 21% reduction of death following recurrence compared with monotherapy (HR, 0.79; 95% CI, 0.64-0.98; P=.03).Conclusions and Relevance: There were no significant differences between the time to recurrence and subsequent and overall survival between local and distant recurrence. Pancreatic cancer behaves as a systemic disease requiring effective systemic therapy after resection.Trial Registration: ClinicalTrials.gov identifier: NCT00058201, EudraCT 2007-004299-38, and ISRCTN 96397434. This secondary analysis of a randomized clinical trial investigates patterns of recurrence after adjuvant chemotherapy in pancreatic cancer and the association with survival.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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Jones, Robert P.
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Psarelli, Eftych ...
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Jackson, Richard
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Ghaneh, Paula
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Halloran, Christ ...
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Palmer, Daniel H ...
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visa fler...
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Campbell, Fiona
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Valle, Juan W.
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Faluyi, Olusola
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O'Reilly, Derek ...
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Cunningham, Davi ...
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Wadsley, Jonatha ...
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Darby, Suzanne
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Meyer, Tim
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Gillmore, Roopin ...
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Anthoney, Alan
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Lind, Pehr
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Glimelius, Bengt
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Falk, Stephen
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Izbicki, Jakob R ...
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Middleton, Gary ...
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Cummins, Sebasti ...
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Ross, Paul J.
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Wasan, Harpreet
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McDonald, Alec
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Crosby, Tom
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Ting, Yuk
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Patel, Kinnari
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Sherriff, David
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Soomal, Rubin
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Borg, David
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Sothi, Sharmila
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Hammel, Pascal
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Lerch, Markus M.
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Mayerle, Julia
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Tjaden, Christin ...
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Strobel, Oliver
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Hackert, Thilo
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Buchler, Markus ...
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Neoptolemos, Joh ...
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Hill, Mark
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Corrie, Pippa
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Hickish, Tamas
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Napier, Mark
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Slater, Sarah
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Valle, Juan
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Shablak, Alaaeld ...
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Cunnell, Michell ...
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Guimbaud, Rosine
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Roques, Tom
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Iveson, Tim
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Jamil, Arshad
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Robinson, Angus
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Garcia-Alonso, A ...
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Chang, David
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Tsang, David
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Wadd, Nick
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Wall, Lucy
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Nielsen, Niels H ...
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Lerch, Markus
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Mehta, Ajay
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Sivaramalingam, ...
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Fyfe, David
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Osborne, Richard
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Blesing, Claire
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Bulusu, Venkata ...
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Rathbone, Emma
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Seitz, Jean-Fran ...
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Beaumont, Erica
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Dernedde, Ulrike
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McAdam, Karen
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Dimopoulos, Prok ...
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Cominos, Mathild ...
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Askill, Colin
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Piwowar, Andrzej
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Bachet, Jean-Bap ...
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Sumpter, Kate
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Raouf, Sherif
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Nicoll, Jonathan
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Rees, Charlotte
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Dhinakaran, Kath ...
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Haux, Johan
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Bengrine-Lefevre ...
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Terrebonne, Eric
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Shankland, Cathe ...
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Palmer, Cheryl
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Medley, Louise
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Toy, Elizabeth
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Kaur, Jasvinder
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Gupta, Kamalnaya ...
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Cheeseman, Sue
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Patterson, Danie ...
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Candish, Charles
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Thompson, Joyce
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Coxon, Fareeda
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Connolly, Caroli ...
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McPhail, Neil
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Williams, Rachel
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Flygare, Petra
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Elmlund, Mattias
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Artru, Pascal
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Millat, Bertrand
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