Jonathan Garnier1, Jacques Ewald2, Ugo Marchese3, Marine Gilabert4, Laurence Moureau-Zabotto5, Marc Giovannini6, Flora Poizat7, Jean-Robert Delpero8, Olivier Turrini9. 1. Department of Surgery, Institut Paoli-Calmettes, Marseille, France. Electronic address: garnierj@ipc.unicancer.fr. 2. Department of Surgery, Institut Paoli-Calmettes, Marseille, France. Electronic address: ewaldj@ipc.unicancer.fr. 3. Department of Surgery, Institut Paoli-Calmettes, Marseille, France. Electronic address: marcheseu@ipc.unicancer.fr. 4. Department of Oncology, Institut Paoli-Calmettes, Marseille, France. Electronic address: gilabertm@ipc.unicancer.fr. 5. Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France. Electronic address: moureaul@ipc.unicancer.fr. 6. Department of Endoscopy, Institut Paoli-Calmettes, Marseille, France. Electronic address: giovanninim@ipc.unicancer.fr. 7. Department of Pathology, Institut Paoli-Calmettes, Marseille, France. Electronic address: poizatf@ipc.unicancer.fr. 8. Department of Surgery, Institut Paoli-Calmettes, Marseille, France. Electronic address: delperojr@ipc.unicancer.fr. 9. Aix-Marseille University, Institut Paoli-Calmettes, Department of Surgery, CNRS, Inserm, CRCM, Marseille, France. Electronic address: turrinio@ipc.unicancer.fr.
Abstract
INTRODUCTION: This study aimed to determine the impact of FOLFIRINOX neoadjuvant therapy on patients with non-metastatic borderline/locally advanced (BL/LA) pancreatic ductal adenocarcinoma (PDAC), in current practice. MATERIAL AND METHODS: From 2010 to 2017, 258 patients with BL/LA PDAC from a single high-volume institution received FOLFIRINOX neoadjuvant treatment. RESULTS: The 258 patients received a median number of 6 cycles of FOLFIRINOX (range, 3-16); 98 (38%) patients underwent curative surgery, and 160 (62%) continued medical treatment. A venous resection was performed in 57 patients (58%), and an arterial resection in 12 (12%). The postoperative 30- and 90-day mortality rates were 6.1% and 8.2%, respectively. Adjuvant chemotherapy was performed in 57 patients (59%). The median overall survival (OS) in patients who did (n = 98) or did not (n = 160) undergo surgical resection were 39 months and 19 months, respectively (P < 0.001). In resected patients, the ASA 3 score (P < 0.01), venous resection (P < 0.01), hemorrhage (P < 0.01), and R1 margin status (P = 0.03) were found to negatively influence the OS. The median OS was significantly higher in patients who did not require a venous resection (not reached vs. 26.5 months, P < 0.001). CONCLUSIONS: Neoadjuvant FOLFIRINOX provided a survival benefit in BL/LA PDAC patients, particularly in those who did not ultimately require venous resection.
INTRODUCTION: This study aimed to determine the impact of FOLFIRINOX neoadjuvant therapy on patients with non-metastatic borderline/locally advanced (BL/LA) pancreatic ductal adenocarcinoma (PDAC), in current practice. MATERIAL AND METHODS: From 2010 to 2017, 258 patients with BL/LA PDAC from a single high-volume institution received FOLFIRINOX neoadjuvant treatment. RESULTS: The 258 patients received a median number of 6 cycles of FOLFIRINOX (range, 3-16); 98 (38%) patients underwent curative surgery, and 160 (62%) continued medical treatment. A venous resection was performed in 57 patients (58%), and an arterial resection in 12 (12%). The postoperative 30- and 90-day mortality rates were 6.1% and 8.2%, respectively. Adjuvant chemotherapy was performed in 57 patients (59%). The median overall survival (OS) in patients who did (n = 98) or did not (n = 160) undergo surgical resection were 39 months and 19 months, respectively (P < 0.001). In resected patients, the ASA 3 score (P < 0.01), venous resection (P < 0.01), hemorrhage (P < 0.01), and R1 margin status (P = 0.03) were found to negatively influence the OS. The median OS was significantly higher in patients who did not require a venous resection (not reached vs. 26.5 months, P < 0.001). CONCLUSIONS: Neoadjuvant FOLFIRINOX provided a survival benefit in BL/LA PDACpatients, particularly in those who did not ultimately require venous resection.
Authors: Quisette P Janssen; Jacob L van Dam; Laura R Prakash; Deesje Doppenberg; Christopher H Crane; Casper H J van Eijck; Susannah G Ellsworth; William R Jarnagin; Eileen M O'Reilly; Alessandro Paniccia; Marsha Reyngold; Marc G Besselink; Matthew H G Katz; Ching-Wei D Tzeng; Amer H Zureikat; Bas Groot Koerkamp; Alice C Wei Journal: J Natl Compr Canc Netw Date: 2022-07 Impact factor: 12.693
Authors: Maxime Lafond; Thomas Lambin; Robert Andrew Drainville; Aurélien Dupré; Mathieu Pioche; David Melodelima; Cyril Lafon Journal: Cancers (Basel) Date: 2022-05-24 Impact factor: 6.575