Intraperitoneal Paclitaxel Treatment for Patients with Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination Provides a Survival Benefit

Yamamoto, Tomohisa; Satoi, Sohei; Yamaki, So; Hashimoto, Daisuke; Ishida, Mitsuaki; Ikeura, Tsukasa; Hirooka, Satoshi; Matsui, Yuki; Boku, Shogen; Nakayama, Shinji; Nakamaru, Koh; Shibata, Nobuhiro; Katsushima, Utae; Sekimoto, Mitsugu

doi:10.3390/cancers14051354

Cited by 7 publications

(12 citation statements)

References 39 publications

(59 reference statements)

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“…33 Moreover, the survival advantage of conversion surgery in patients with UR-PDAC with favorable responses to chemotherapy has been described in recent studies. 34 The present study also demonstrated better survival in patients who received preoperative chemotherapy for both Pb-and Pt-PDAC, and that the status of LN metastasis was significantly associated with OS even after preoperative therapy. Importantly, the incidence and extent of LN metastasis decreased in patients who received preoperative therapy for both Pb-and Pt-PDAC.…”

Section: Discussionsupporting

confidence: 73%

“…Currently, Japanese guidelines recommend surgery after neoadjuvant chemotherapy for R/BR PDAC as a general rule 33 . Moreover, the survival advantage of conversion surgery in patients with UR‐PDAC with favorable responses to chemotherapy has been described in recent studies 34 . The present study also demonstrated better survival in patients who received preoperative chemotherapy for both Pb‐ and Pt‐PDAC, and that the status of LN metastasis was significantly associated with OS even after preoperative therapy.…”

Section: Discussionsupporting

confidence: 68%

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Reevaluation of regional lymph nodes in patients with pancreatic ductal adenocarcinoma in the pancreatic body and tail

Matsui

Hashimoto

Satoi

et al. 2022

Annals of Gastroent Surgery

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Introduction:In patients with pancreatic ductal adenocarcinoma (PDAC) in the pancreatic body (Pb) and tail (Pt), the appropriate area for lymphadenectomy is controversial. This study aimed to reevaluate the extent of lymph node (LN) metastasis in Pb-and Pt-PDAC, and to define the optimal area of LN dissection. Patients and methods:This single-center retrospective study evaluated patients with Pb-and Pt-PDAC who underwent distal pancreatectomy with extended lymphadenectomy between 2006 and 2020. LN metastasis in >3.0% of patients were defined as new regional LN. Results:The study cohort included 135 patients with Pb-PDAC and 42 patients with Pt-PDAC. In patients with Pb-PDAC, LNs around the splenic artery (SPA) had the highest metastasis-positive rate (54.1%). LNs along the left gastric artery, common hepatic artery, celiac axis (CA), superior mesenteric artery (SMA), and splenic hilus were defined as new regional LNs. In patients with Pt-PDAC, LNs at the splenic hilum had the highest metastasis-positive rate (38.1%). The station and LN around the SPA were defined as new regional LNs in those with Pt-PDAC. Metastasis beyond the newly defined regional LNs was not associated with survival. The incidence of LN metastasis was lower in patients who received preoperative chemotherapy than in those who underwent upfront surgery in both Pb-and Pt-PDAC. Conclusion:Although it needs to be verified in future multicenter studies, LN of both the CA and SMA systems should be dissected in patients with Pb-PDAC. However, only those around the SPA and splenic hilus should be dissected routinely in those with Pt-PDAC.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 68%

Reevaluation of regional lymph nodes in patients with pancreatic ductal adenocarcinoma in the pancreatic body and tail

Matsui

Hashimoto

Satoi

et al. 2022

Annals of Gastroent Surgery

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“…In pancreatic cancer, the definition of peritoneal oligometastasis has rarely been discussed and established. Previous studies have found that conversion surgery and OS rates in peritoneal metastatic pancreatic cancer were unfavorable, with a prognosis ranged from 5.3 to 12.9 months (Table 2) [9,17,[20][21][22][23][24]. In contrast, Satoi et al [22] reported remarkable outcomes in patients with peritoneal metastasis treated with conversion surgery after a favorable response to intravenous and intraperitoneal paclitaxel with S-1.…”

Section: Surgery For Peritoneal Oligometastasismentioning

confidence: 98%

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

Sho

Yasuda

Nagai

et al. 2023

JDCR

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Pancreatic cancer is one of the most difficult human malignancies to treat. Surgery is generally contraindicated in advanced pancreatic cancer, even with one distant metastatic lesion [1]. However, recent advancements in the treatment of pancreatic cancer may change therapeutic concepts and strategies, even for metastatic pancreatic cancer. Even in cases of advanced pancreatic cancer, we occasionally see unexpectedly positive benefits of anticancer therapy in daily clinical practice. In such cases, surgical resection might result in long-term survival or even a complete cure. Oligometastasis is considered an intermediate state between localized and polymetastatic disease [2]. Currently, the best treatment for oligometastasis in pancreatic cancer, despite being widely discussed, remains controversial. There are several clinical questions regarding oligometastasis in pancreatic cancer. First, what is the definition of oligometastasis in pancreatic cancer? Second, does surgery play a significant role in the multidisciplinary treatment, even in patients with oligometastasis? Third, what is an appropriate biomarker to predict efficacy of treatment and determine surgical indications in oligometastatic pancreatic cancer?In this review, we present an update on the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer, and discuss future perspectives.

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“… 46 , 47 Three reports were published on peritoneal mPDAC in 2021 and 2022 (Table 3 ). 16 , 48 , 49 Yamada et al reported a summary of two previous prospective studies on IP therapy for peritoneal mPDAC, focusing on conversion surgery. 48 Yamamoto et al 49 compared patients with IP treatment and conventional chemotherapy, of whom 12 underwent conversion surgery.…”

Section: Peritoneal Oligometastasismentioning

confidence: 99%

Essential updates 2021/2022: Surgical outcomes of oligometastasis in pancreatic ductal adenocarcinoma

Yasuda

Nagai

Terai

et al. 2023

Annals of Gastroent Surgery

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Oligometastatic disease has been proposed as an intermediate state between localized and polymetastatic disease that can benefit from multimodal treatment, including surgery. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma, although there is still little evidence. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarized the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives. In liver oligometastasis, multimodal treatment including surgery achieved favorable long‐term survival, especially in patients with good responses to preoperative chemotherapy, with a median survival time from 25.5 to 54.6 months. In addition, the data from the National Cancer Database in the United States showed that patients who underwent surgery for oligometastatic liver metastases had a significantly longer overall survival than those who received chemotherapy alone. Prognostic biomarkers were identified, including carbohydrate antigen 19–9 (CA19‐9) levels at diagnosis and preoperative chemotherapy with normalization of CA19‐9 levels or favorable radiological response. Patients with lung oligometastasis had a more favorable long‐term prognosis than those with other recurrence sites, and the updated literature further confirmed the previous studies. Overall survival was favorable, with 84 months after initial surgery and 29.2 months after metastasectomy, and a 5‐year survival rate of 60.6% was also reported. In peritoneal oligometastasis, the results of conversion surgery after good responses to preoperative treatment with intraperitoneal therapy or systematic chemotherapy were reported, and the conversion rate and long‐term prognosis were favorable. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarize the current status of surgery in multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives.

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Intraperitoneal Paclitaxel Treatment for Patients with Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination Provides a Survival Benefit

Cited by 7 publications

References 39 publications

Reevaluation of regional lymph nodes in patients with pancreatic ductal adenocarcinoma in the pancreatic body and tail

Reevaluation of regional lymph nodes in patients with pancreatic ductal adenocarcinoma in the pancreatic body and tail

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

Essential updates 2021/2022: Surgical outcomes of oligometastasis in pancreatic ductal adenocarcinoma

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