Pathological complete response in patients with resected pancreatic adenocarcinoma after preoperative chemotherapy

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Pathological complete response in patients with resected pancreatic adenocarcinoma after preoperative chemotherapy

Stoop, Thomas F. (författare): 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

Oba, Atsushi (författare): 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

Wu, Y H Andrew (författare): 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. (författare): Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, United States

Colborn, Kathryn L. (författare): 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

Janssen, Boris V. (författare): University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands

Al-Musawi, Mohammed H. (författare): Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States

Franco, Salvador Rodriguez (författare): Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States

Sugawara, Toshitaka (författare): 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

Franklin, Oskar, 1985- (författare): Umeå universitet,Institutionen för diagnostik och intervention,Kirurgi,Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States

Jain, Ajay (författare): Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States

Saiura, Akio (författare): Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan

Sauvanet, Alain (författare): Department of Surgery, Hôpital Beaujon, Clichy, France

Coppola, Alessandro (författare): Dipartimento di Chirurgia Sapienza Università di Roma, Rome, Italy

Javed, Ammar A. (författare): 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

Groot Koerkamp, Bas (författare): Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands

Miller, Braden N. (författare): Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States

Mack, Claudia E. (författare): Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany

Hashimoto, Daisuke (författare): Department of Surgery, Kansai Medical University, Osaka, Japan

Caputo, Damiano (författare): , 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

Kleive, Dyre (författare): Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Sereni, Elisabetta (författare): 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

Belfiori, Giulio (författare): Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy

Ichida, Hirofumi (författare): Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Tokyo, Japan

van Dam, Jacob L. (författare): Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands

Dembinski, Jeanne (författare): Department of Surgery, Hôpital Beaujon, Clichy, France

Akahoshi, Keiichi (författare): Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Roberts, Keith J. (författare): Hepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom

Tanaka, Kimitaka (författare): Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan

Labori, Knut J. (författare): Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Falconi, Massimo (författare): Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy

House, Michael G. (författare): Department of Surgery, Indiana University School of Medicine, Indianapolis, United States

Sugimoto, Motokazu (författare): Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan

Tanabe, Minoru (författare): Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Gotohda, Naoto (författare): Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan

Krohn, Paul S. (författare): Department of Surgery and Transplantation, Copenhagen University Hospital, Copenhagen, Denmark

Burkhart, Richard A. (författare): 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

Thakkar, Rohan G. (författare): Department of Hepato-Pancreatico-Biliary and Transplant Surgery, Freeman Hospital, Newcastle University, Newcastle upon Tyne, United Kingdom

Pande, Rupaly (författare): Hepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom

Dokmak, Safi (författare): Department of Surgery, Hôpital Beaujon, Clichy, France

Hirano, Satoshi (författare): Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan

Burgdorf, Stefan K. (författare): Department of Surgery and Transplantation, Copenhagen University Hospital, Copenhagen, Denmark

Crippa, Stefano (författare): Pancreatic and Transplant Surgery Unit, San Raffaele Hospital IRCCS, Vita-Salute University, Milano, Italy

van Roessel, Stijn (författare): University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands

Satoi, Sohei (författare): Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States; Department of Surgery, Kansai Medical University, Osaka, Japan

White, Steven A. (författare): Department of Hepato-Pancreatico-Biliary and Transplant Surgery, Freeman Hospital, Newcastle University, Newcastle upon Tyne, United Kingdom

Hackert, Thilo (författare): Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany

Nguyen, Trang K. (författare): Department of Surgery, Indiana University School of Medicine, Indianapolis, United States

Yamamoto, Tomohisa (författare): Department of Surgery, Kansai Medical University, Osaka, Japan

Nakamura, Toru (författare): Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine, Hokkaido, Japan

Bachu, Vismaya (författare): 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

Burns, William R. (författare): 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

Inoue, Yosuke (författare): Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

Takahashi, Yu (författare): Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

Ushida, Yuta (författare): Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

Aslami, Zohra V. (författare): 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

Verbeke, Caroline S. (författare): Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway

Fariña, Arantza (författare): Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands

He, Jin (författare): 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

Wilmink, Johanna W. (författare): Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Medical Oncology, Amsterdam, Netherlands

Messersmith, Wells (författare): Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, United States

Verheij, Joanne (författare): Cancer Center Amsterdam, Amsterdam, Netherlands; University of Amsterdam, Department of Pathology, Amsterdam, Netherlands

Kaplan, Jeffrey (författare): Department of Pathology, University of Colorado School of Medicine, Aurora, United States

Schulick, Richard D. (författare): Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States

Besselink, Marc G. (författare): University of Amsterdam, Department of Surgery, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands

Del Chiaro, Marco (författare): Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, United States

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American Medical Association (AMA), 2024
2024
Engelska.
Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 7:6

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://umu.diva-por... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

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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.

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Av författaren/redakt...: Stoop, Thomas F.; Oba, Atsushi; Wu, Y H Andrew; Beaty, Laurel E.; Colborn, Kathryn ...; Janssen, Boris V ...; visa fler...; Al-Musawi, Moham ...; Franco, Salvador ...; Sugawara, Toshit ...; Franklin, Oskar, ...; Jain, Ajay; Saiura, Akio; Sauvanet, Alain; Coppola, Alessan ...; Javed, Ammar A.; Groot Koerkamp, ...; Miller, Braden N ...; Mack, Claudia E.; Hashimoto, Daisu ...; Caputo, Damiano; Kleive, Dyre; Sereni, Elisabet ...; Belfiori, Giulio; Ichida, Hirofumi; van Dam, Jacob L ...; Dembinski, Jeann ...; Akahoshi, Keiich ...; Roberts, Keith J ...; Tanaka, Kimitaka; Labori, Knut J.; Falconi, Massimo; House, Michael G ...; Sugimoto, Motoka ...; Tanabe, Minoru; Gotohda, Naoto; Krohn, Paul S.; Burkhart, Richar ...; Thakkar, Rohan G ...; Pande, Rupaly; Dokmak, Safi; Hirano, Satoshi; Burgdorf, Stefan ...; Crippa, Stefano; van Roessel, Sti ...; Satoi, Sohei; White, Steven A.; Hackert, Thilo; Nguyen, Trang K.; Yamamoto, Tomohi ...; Nakamura, Toru; Bachu, Vismaya; Burns, William R ...; Inoue, Yosuke; Takahashi, Yu; Ushida, Yuta; Aslami, Zohra V.; Verbeke, Carolin ...; Fariña, Arantza; He, Jin; Wilmink, Johanna ...; Messersmith, Wel ...; Verheij, Joanne; Kaplan, Jeffrey; Schulick, Richar ...; Besselink, Marc ...; Del Chiaro, Marc ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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Av lärosätet: Umeå universitet

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Pathological complete response in patients with resected pancreatic adenocarcinoma after preoperative chemotherapy

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