FOLFIRINOX induction therapy for stage III pancreatic adenocarcinoma

Sadot, Eran; Duossot, Alexandre; O’Reilly, Eileen M.; Gönen, Mithat; Kingham, T. Peter; D’Angelica, Michael I.; Fong, Yuman; DeMatteo, Ronald P.; Jarnagin, William R.; Allen, Peter J.

doi:10.1016/j.jamcollsurg.2014.07.862

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…3,4 However, it is well known that these and other high-volume centers have expanded their patient selection for PD in the current era of upfront FOLFIR-INOX chemotherapy. [43][44][45] The present series includes 27 patients with initially locally-advanced disease who could undergo resection after induction systemic therapy (mostly FOLFIRINOX).…”

Section: Discussionmentioning

confidence: 99%

Impact of expanding indications on surgical and oncological outcome in 1434 consecutive pancreatoduodenectomies

Roessel

Mackay

Tol

et al. 2019

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Background: Over the years, high-volume pancreatic centers expanded their indications for pancreatoduodenectomy (PD) but with unknown impact on surgical and oncological outcome.Methods: All consecutive PDs performed between 1992-2017 in a single pancreatic center were identified from a prospectively maintained database and analyzed according to three time periods. Results: In total, 1434 patients underwent PD. Over time, more elderly patients underwent PD (P < 0.001) with increased use of vascular resection (10.4 to 16.0%, P < 0.001). In patients with cancer (n = 1049, 74.8%), the proportion pT3/T4 tumors increased from 54.3% to 70.6% over time (P < 0.001). The postoperative pancreatic fistula (16.0%), postpancreatectomy hemorrhage (8.0%) and delayed gastric emptying (31.0%) rate did not reduce over time, whereas median length of stay decreased from 16 to 12 days (P < 0.001). The overall failure-to-rescue rate (6.9%) and in-hospital mortality (2.2%) remained stable (P = 0.89 and P = 0.45). In 523 patients with pancreatic cancer (36.5%), the use of both adjuvant and neoadjuvant chemotherapy increased over time (both p<0.001), and the five-year overall survival improved from 11.0% to 17.4% (P < 0.001). Conclusions:In a period where indications for PD expanded, with more elderly patients, more advanced cancers and increased use of vascular resections, surgical outcome remained favorable and five-year survival for pancreatic cancer improved.

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Section: Discussionmentioning

confidence: 99%

Impact of expanding indications on surgical and oncological outcome in 1434 consecutive pancreatoduodenectomies

Roessel

Mackay

Tol

et al. 2019

HPB

View full text Add to dashboard Cite

show abstract

“…The manuscript by Sadot and colleagues from Memorial Sloan Kettering Cancer Center (MSKCC) in this issue of Annals of Surgical Oncology, now extends the possible role for surgery even further, to include patients with locally advanced disease. 6 They applied a robust neoadjuvant systemic therapy (FOLFIRINOX), often followed by chemoradiation, and then reconsidered surgery in patients with responding disease. The objective response rate ([30 % decrease in the largest dimension of the tumor) with FOLFIRINOX and chemoradiation was 29 % and almost one-third of patients underwent surgical resection of their primary pancreatic cancer.…”

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confidence: 99%