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Pathological comple...
Pathological complete response in patients with resected pancreatic adenocarcinoma after preoperative chemotherapy
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- Stoop, Thomas F. (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
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- Oba, Atsushi (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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- Wu, Y H Andrew (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Beaty, Laurel E. (author)
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, United States
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- Colborn, Kathryn L. (author)
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, United States
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- Janssen, Boris V. (author)
- University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands
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- Al-Musawi, Mohammed H. (author)
- Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States
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- Franco, Salvador Rodriguez (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States
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- Sugawara, Toshitaka (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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- Franklin, Oskar, 1985- (author)
- Umeå universitet,Institutionen för diagnostik och intervention,Kirurgi,Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States
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- Jain, Ajay (author)
- Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States
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- Saiura, Akio (author)
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Sauvanet, Alain (author)
- Department of Surgery, Hôpital Beaujon, Clichy, France
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- Coppola, Alessandro (author)
- Dipartimento di Chirurgia Sapienza Università di Roma, Rome, Italy
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- Javed, Ammar A. (author)
- University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia; Division of Surgical Oncology, Department of Surgery, New York University Medical Center, NY, United States
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- Groot Koerkamp, Bas (author)
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
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- Miller, Braden N. (author)
- Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States
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- Mack, Claudia E. (author)
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
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- Hashimoto, Daisuke (author)
- Department of Surgery, Kansai Medical University, Osaka, Japan
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- Caputo, Damiano (author)
- , Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Research Unit of General Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
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- Kleive, Dyre (author)
- Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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- Sereni, Elisabetta (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia; Unit of General and Pancreatic Surgery, Pancreas Institute, University of Verona Hospital Truty, Verona, Italy
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- Belfiori, Giulio (author)
- Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy
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- Ichida, Hirofumi (author)
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- van Dam, Jacob L. (author)
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands
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- Dembinski, Jeanne (author)
- Department of Surgery, Hôpital Beaujon, Clichy, France
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- Akahoshi, Keiichi (author)
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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- Roberts, Keith J. (author)
- Hepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom
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- Tanaka, Kimitaka (author)
- Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan
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- Labori, Knut J. (author)
- Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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- Falconi, Massimo (author)
- Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy
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- House, Michael G. (author)
- Department of Surgery, Indiana University School of Medicine, Indianapolis, United States
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- Sugimoto, Motokazu (author)
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan
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- Tanabe, Minoru (author)
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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- Gotohda, Naoto (author)
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan
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- Krohn, Paul S. (author)
- Department of Surgery and Transplantation, Copenhagen University Hospital, Copenhagen, Denmark
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- Burkhart, Richard A. (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Thakkar, Rohan G. (author)
- Department of Hepato-Pancreatico-Biliary and Transplant Surgery, Freeman Hospital, Newcastle University, Newcastle upon Tyne, United Kingdom
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- Pande, Rupaly (author)
- Hepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom
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- Dokmak, Safi (author)
- Department of Surgery, Hôpital Beaujon, Clichy, France
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- Hirano, Satoshi (author)
- Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan
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- Burgdorf, Stefan K. (author)
- Department of Surgery and Transplantation, Copenhagen University Hospital, Copenhagen, Denmark
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- Crippa, Stefano (author)
- Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy
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- van Roessel, Stijn (author)
- University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
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- Satoi, Sohei (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; Department of Surgery, Kansai Medical University, Osaka, Japan
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- White, Steven A. (author)
- Department of Hepato-Pancreatico-Biliary and Transplant Surgery, Freeman Hospital, Newcastle University, Newcastle upon Tyne, United Kingdom
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- Hackert, Thilo (author)
- Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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- Nguyen, Trang K. (author)
- Department of Surgery, Indiana University School of Medicine, Indianapolis, United States
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- Yamamoto, Tomohisa (author)
- Department of Surgery, Kansai Medical University, Osaka, Japan
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- Nakamura, Toru (author)
- Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan
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- Bachu, Vismaya (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Burns, William R. (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Inoue, Yosuke (author)
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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- Takahashi, Yu (author)
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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- Ushida, Yuta (author)
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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- Aslami, Zohra V. (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Verbeke, Caroline S. (author)
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway
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- Fariña, Arantza (author)
- Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands
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- He, Jin (author)
- Division of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, MD, Baltimore, Liberia; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, MD, Baltimore, Liberia
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- Wilmink, Johanna W. (author)
- Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Medical Oncology, Amsterdam, Netherlands
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- Messersmith, Wells (author)
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, United States
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- Verheij, Joanne (author)
- Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands
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- Kaplan, Jeffrey (author)
- Department of Pathology, University of Colorado School of Medicine, Aurora, United States
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- Schulick, Richard D. (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States
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- Besselink, Marc G. (author)
- University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
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- Del Chiaro, Marco (author)
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States
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(creator_code:org_t)
- American Medical Association (AMA), 2024
- 2024
- English.
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In: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 7:6
- Related links:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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Abstract
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- Importance: Preoperative chemo(radio)therapy is increasingly used in patients with localized pancreatic adenocarcinoma, leading to pathological complete response (pCR) in a small subset of patients. However, multicenter studies with in-depth data about pCR are lacking.Objective: To investigate the incidence, outcome, and risk factors of pCR after preoperative chemo(radio)therapy.Design, Setting, and Participants: This observational, international, multicenter cohort study assessed all consecutive patients with pathology-proven localized pancreatic adenocarcinoma who underwent resection after 2 or more cycles of chemotherapy (with or without radiotherapy) in 19 centers from 8 countries (January 1, 2010, to December 31, 2018). Data collection was performed from February 1, 2020, to April 30, 2022, and analyses from January 1, 2022, to December 31, 2023. Median follow-up was 19 months.Exposures: Preoperative chemotherapy (with or without radiotherapy) followed by resection.Main Outcomes and Measures: The incidence of pCR (defined as absence of vital tumor cells in the sampled pancreas specimen after resection), its association with OS from surgery, and factors associated with pCR. Factors associated with overall survival (OS) and pCR were investigated with Cox proportional hazards and logistic regression models, respectively.Results: Overall, 1758 patients (mean [SD] age, 64 [9] years; 879 [50.0%] male) were studied. The rate of pCR was 4.8% (n = 85), and pCR was associated with OS (hazard ratio, 0.46; 95% CI, 0.26-0.83). The 1-, 3-, and 5-year OS rates were 95%, 82%, and 63% in patients with pCR vs 80%, 46%, and 30% in patients without pCR, respectively (P < .001). Factors associated with pCR included preoperative multiagent chemotherapy other than (m)FOLFIRINOX ([modified] leucovorin calcium [folinic acid], fluorouracil, irinotecan hydrochloride, and oxaliplatin) (odds ratio [OR], 0.48; 95% CI, 0.26-0.87), preoperative conventional radiotherapy (OR, 2.03; 95% CI, 1.00-4.10), preoperative stereotactic body radiotherapy (OR, 8.91; 95% CI, 4.17-19.05), radiologic response (OR, 13.00; 95% CI, 7.02-24.08), and normal(ized) serum carbohydrate antigen 19-9 after preoperative therapy (OR, 3.76; 95% CI, 1.79-7.89).Conclusions and Relevance: This international, retrospective cohort study found that pCR occurred in 4.8% of patients with resected localized pancreatic adenocarcinoma after preoperative chemo(radio)therapy. Although pCR does not reflect cure, it is associated with improved OS, with a doubled 5-year OS of 63% compared with 30% in patients without pCR. Factors associated with pCR related to preoperative chemo(radio)therapy regimens and anatomical and biological disease response features may have implications for treatment strategies that require validation in prospective studies because they may not universally apply to all patients with pancreatic adenocarcinoma.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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- By the author/editor
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Stoop, Thomas F.
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Oba, Atsushi
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Wu, Y H Andrew
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Beaty, Laurel E.
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Colborn, Kathryn ...
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Janssen, Boris V ...
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Al-Musawi, Moham ...
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Franco, Salvador ...
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Sugawara, Toshit ...
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Franklin, Oskar, ...
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Jain, Ajay
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Saiura, Akio
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Sauvanet, Alain
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Coppola, Alessan ...
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Javed, Ammar A.
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Groot Koerkamp, ...
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Miller, Braden N ...
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Mack, Claudia E.
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Hashimoto, Daisu ...
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Caputo, Damiano
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Kleive, Dyre
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Sereni, Elisabet ...
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Belfiori, Giulio
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Ichida, Hirofumi
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van Dam, Jacob L ...
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Dembinski, Jeann ...
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Akahoshi, Keiich ...
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Roberts, Keith J ...
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Tanaka, Kimitaka
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Labori, Knut J.
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Falconi, Massimo
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House, Michael G ...
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Sugimoto, Motoka ...
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Tanabe, Minoru
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Gotohda, Naoto
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Krohn, Paul S.
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Burkhart, Richar ...
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Thakkar, Rohan G ...
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Pande, Rupaly
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Dokmak, Safi
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Hirano, Satoshi
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Burgdorf, Stefan ...
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Crippa, Stefano
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van Roessel, Sti ...
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Satoi, Sohei
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White, Steven A.
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Hackert, Thilo
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Nguyen, Trang K.
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Yamamoto, Tomohi ...
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Nakamura, Toru
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Bachu, Vismaya
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Burns, William R ...
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Inoue, Yosuke
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Takahashi, Yu
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Ushida, Yuta
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Aslami, Zohra V.
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Verbeke, Carolin ...
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Fariña, Arantza
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He, Jin
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Wilmink, Johanna ...
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Messersmith, Wel ...
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Verheij, Joanne
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Kaplan, Jeffrey
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Schulick, Richar ...
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Besselink, Marc ...
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Del Chiaro, Marc ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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Umeå University