Survival benefit of resection of locally advanced pancreatic cancer following upfront FOLFIRINOX versus FOLFIRINOX only treatment: a multicenter propensity score-matched analysis

Brada, Lilly J H; Daamen, Lois A; Magermans, L.; Walma, Marieke S.; Latifi, Diba; Dam, R. Van; Hingh, Ignace de; Liem, M.; Meijer, V. de; Patijn, Gijs A.; Festen, Sebastiaan; Stommel, M.; Bosscha, K.; Polée, Marco B.; Nio, C. Yung; Wessels, Frank J.; Vries, Jan de; Lienden, Krijn van; Bruijnen, R.; Busch, Olivier R.; Koerkamp, B. Groot; Eijck, C. van; Molenaar, I.; Wilmink, J.; Santvoort, H. van; Besselink, M.

doi:10.1016/j.hpb.2021.06.070

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“…Equal distribution of the baseline characteristics was tested using standardized mean difference (SMD), with an overall SMD of < 0.10 representing a good balance. 26 Survival rates were calculated using the Kaplan-Meier method, and were compared between the groups using the logrank test. Univariate Cox regression model was used to explore the potential risk factors associated with recurrence and survival time.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Study Using Propensity Score Matching to Compare Long-term Survival Outcomes After Robotic-assisted, Laparoscopic, or Open Liver Resection for Patients With BCLC Stage 0-A Hepatocellular Carcinoma

et al. 2022

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Objective: To compare the short-and long-term outcomes of robotassisted (RALR), laparoscopic (LLR), or open liver resection (OLR) in the treatment of Barcelona Clinic Liver Cancer (BCLC) stage 0-A hepatocellular carcinoma (HCC). Summary Background Data: Following the Balliol IDEAL classification, long-term oncological outcomes can be used to evaluate the value of minimally invasive techniques in the treatment of HCC, and to assess whether they should become a standard practice. Methods: Data from prospective cohorts of patients with BCLC stage 0-A HCC who underwent curative liver resection using OLR, LLR, or RALR at Tongji Hospital were reviewed. The short-term and long-term oncological outcomes of these 3 different surgical approaches after adequate follow-up were compared using propensity score matching to reduce selection bias. Results: Of 369 patients included in this study (71, RALR; 141, LLR; and 157, OLR), 56 patients in each of the 3 groups were chosen for further comparison, after propensity score matching. In the minimally invasive group (RALR+LLR), both the operative time and duration of Pringle's maneuver were significantly longer than those in the OLR group; however, the length of hospital stay was significantly shorter. There were no significant differences in the other intraoperative parameters and the incidence of postoperative complications among the 3 groups. HCC recurrence in the minimally invasive group when compared with the OLR group was characterized by a significantly higher proportion of single lesion or early-stage HCC. However, there were no significant differences in the 5-year disease-free survival (63.8%, 54.4%, and 50.6%) or overall survival rates (80.8%, 78.6%, and 75.7%, respectively) among the 3 groups. Clinically significant portal hypertension was the only risk factor that negatively affected the 5-year disease-free survival rate. Multivariate Cox regression analysis showed that clinically significant portal hypertension, serum alpha-fetoprotein level (≥400 ng/ mL), and Edmondson-Steiner grading (III+IV) were independent risk factors for poor long-term survival. Conclusion: Both robotic and laparoscopic hepatectomies were safe and effective for patients with BCLC stage 0-A HCC when compared with open hepatectomy.

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Section: Discussionmentioning

confidence: 99%

“…Equal distribution of the baseline characteristics was tested using standardized mean difference (SMD), with an overall SMD of <0.10 representing a good balance. 26…”

Section: Methodsmentioning

confidence: 99%