Neoadjuvant FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer: An intention to treat analysis

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Alex BarenboimNir Lubezky

Abstract

To assess clinical and pathologic efficacy of neoadjuvant FOLFIRINOX for locally advanced (LAPC) and borderline resectable pancreatic cancer (BRPC). Patients receiving neoadjuvant FOLFIRINOX for LAPC and BRPC treated between 2014 and 2017 were identified. Post-treatment patients achieving resectability were referred for surgery, whereas unresectable patients continued chemotherapy. Clinical and pathological data were retrospectively compared with control group consisting of 47 consecutive patients with BRPC undergoing pancreatic and portal vein resection between 2008 and 2017. Thirty LAPC and 23 BRPC patients were identified. Reasons for unresectability included disease progression (70%), locally unresectable disease (18%), and poor performance status (11%). Three patients (10%) with LAPC, and 20 (87%) with BRPC underwent curative surgery. Compared with control group, perioperative complication rate (4.3% versus 28.9%, p = 0.016), and pancreatic fistula rate (0 versus 14.8%, p = 0.08) were lower. Peripancreatic fat invasion (52.2% vs 97.8%, p = 0.001), lymph node involvement (22% vs 54.3%, p = 0.01), and surgical margin involvement (0 vs 17.4%, p = 0.04) were higher in the control group. Median survival was 34.3 months in BRPC ...Continue Reading

Citations

Jan 17, 2019·Langenbeck's Archives of Surgery·Hiroshi KuraharaMasafumi Nakamura
Jul 22, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shohei YoshiyaMasaki Mori
Sep 29, 2020·Therapeutic Advances in Medical Oncology·Changhoon YooBaek-Yeol Ryoo
Nov 12, 2020·International Journal of Clinical Oncology·Tsuyoshi TakedaNaoki Sasahira
Feb 22, 2021·Japanese Journal of Clinical Oncology·Tsuyoshi TakedaNaoki Sasahira
Dec 17, 2019·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·J MedranoO Turrini
Jun 22, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·UNKNOWN Committee of the Korean clinical practice guideline for pancreatic cancer and National Cancer Center, Korea
Nov 9, 2021·Future Oncology·Monish Karunakaran, Savio George Barreto

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