TY - JOUR
T1 - Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer
T2 - An International Multicenter Cohort Study
AU - on behalf of the Scientific Committee of the European-African Hepato-Pancreato-Biliary Association
AU - van Veldhuisen, Eran
AU - Klompmaker, Sjors
AU - Janssen, Quisette P.
AU - Hilal, Mohammed Abu
AU - Alseidi, Adnan
AU - Balduzzi, Alberto
AU - Balzano, Gianpaolo
AU - Bassi, Claudio
AU - Berrevoet, Frederik
AU - Bonds, Morgan
AU - Busch, Olivier R.
AU - Butturini, Giovanni
AU - Conlon, Kevin C.
AU - Frigerio, Isabella M.
AU - Fusai, Giuseppe K.
AU - Gagnière, Johan
AU - Griffin, Oonagh
AU - Hackert, Thilo
AU - Halimi, Asif
AU - Keck, Tobias
AU - Kleeff, Jörg
AU - Klaiber, Ulla
AU - Labori, Knut J.
AU - Lesurtel, Mickael
AU - Malleo, Giuseppe
AU - Marino, Marco V.
AU - Molenaar, I. Quintus
AU - Mortensen, Michael B.
AU - Nikov, Andrej
AU - Pagnanelli, Michele
AU - Pandé, Rupaly
AU - Pfeiffer, Per
AU - Pietrasz, Daniel
AU - Rangelova, Elena
AU - Roberts, Keith J.
AU - Cunha, Antonio Sa
AU - Salvia, Roberto
AU - Strobel, Oliver
AU - Tarvainen, Timo
AU - Wilmink, Johanna W.
AU - Koerkamp, Bas Groot
AU - Besselink, Marc G.
AU - Sauvanet, Alain
AU - Marthey, Lysiane
AU - Marthey, Lysiane
AU - Laurent, Christophe
AU - Régenet, Nicolas
AU - Coriat, Romain
AU - Taieb, Julien
AU - Turini, Olivier
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2023/3
Y1 - 2023/3
N2 - Background: Preoperative FOLFIRINOX chemotherapy is increasingly administered to patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) to improve overall survival (OS). Multicenter studies reporting on the impact from the number of preoperative cycles and the use of adjuvant chemotherapy in relation to outcomes in this setting are lacking. This study aimed to assess the outcome of pancreatectomy after preoperative FOLFIRINOX, including predictors of OS. Methods: This international multicenter retrospective cohort study included patients from 31 centers in 19 European countries and the United States undergoing pancreatectomy after preoperative FOLFIRINOX chemotherapy (2012–2016). The primary end point was OS from diagnosis. Survival was assessed using Kaplan-Meier analysis and Cox regression. Results: The study included 423 patients who underwent pancreatectomy after a median of six (IQR 5–8) preoperative cycles of FOLFIRINOX. Postoperative major morbidity occurred for 88 (20.8%) patients and 90-day mortality for 12 (2.8%) patients. An R0 resection was achieved for 243 (57.4%) patients, and 259 (61.2%) patients received adjuvant chemotherapy. The median OS was 38 months (95% confidence interval [CI] 34–42 months) for BRPC and 33 months (95% CI 27–45 months) for LAPC. Overall survival was significantly associated with R0 resection (hazard ratio [HR] 1.63; 95% CI 1.20–2.20) and tumor differentiation (HR 1.43; 95% CI 1.08–1.91). Neither the number of preoperative chemotherapy cycles nor the use adjuvant chemotherapy was associated with OS. Conclusions: This international multicenter study found that pancreatectomy after FOLFIRINOX chemotherapy is associated with favorable outcomes for patients with BRPC and those with LAPC. Future studies should confirm that the number of neoadjuvant cycles and the use adjuvant chemotherapy have no relation to OS after resection.
AB - Background: Preoperative FOLFIRINOX chemotherapy is increasingly administered to patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) to improve overall survival (OS). Multicenter studies reporting on the impact from the number of preoperative cycles and the use of adjuvant chemotherapy in relation to outcomes in this setting are lacking. This study aimed to assess the outcome of pancreatectomy after preoperative FOLFIRINOX, including predictors of OS. Methods: This international multicenter retrospective cohort study included patients from 31 centers in 19 European countries and the United States undergoing pancreatectomy after preoperative FOLFIRINOX chemotherapy (2012–2016). The primary end point was OS from diagnosis. Survival was assessed using Kaplan-Meier analysis and Cox regression. Results: The study included 423 patients who underwent pancreatectomy after a median of six (IQR 5–8) preoperative cycles of FOLFIRINOX. Postoperative major morbidity occurred for 88 (20.8%) patients and 90-day mortality for 12 (2.8%) patients. An R0 resection was achieved for 243 (57.4%) patients, and 259 (61.2%) patients received adjuvant chemotherapy. The median OS was 38 months (95% confidence interval [CI] 34–42 months) for BRPC and 33 months (95% CI 27–45 months) for LAPC. Overall survival was significantly associated with R0 resection (hazard ratio [HR] 1.63; 95% CI 1.20–2.20) and tumor differentiation (HR 1.43; 95% CI 1.08–1.91). Neither the number of preoperative chemotherapy cycles nor the use adjuvant chemotherapy was associated with OS. Conclusions: This international multicenter study found that pancreatectomy after FOLFIRINOX chemotherapy is associated with favorable outcomes for patients with BRPC and those with LAPC. Future studies should confirm that the number of neoadjuvant cycles and the use adjuvant chemotherapy have no relation to OS after resection.
UR - http://www.scopus.com/inward/record.url?scp=85144725080&partnerID=8YFLogxK
U2 - 10.1245/s10434-022-12387-2
DO - 10.1245/s10434-022-12387-2
M3 - Journal articles
C2 - 36539580
AN - SCOPUS:85144725080
SN - 1068-9265
VL - 30
SP - 1463
EP - 1473
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 3
ER -
