| Institution: | 1. Department of Surgery, Institut Paoli-Calmettes, Marseille, France;2. Department of Oncology, Institut Paoli-Calmettes, Marseille, France;3. Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France;4. Department of Endoscopy, Institut Paoli-Calmettes, Marseille, France;5. Department of Pathology, Institut Paoli-Calmettes, Marseille, France;6. Aix-Marseille University, Institut Paoli-Calmettes, Department of Surgery, CNRS, Inserm, CRCM, Marseille, France;1. Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, Università Vita Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy;2. Department of Pathology, Università Vita Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy;3. Department of Pathology, Università Politecnica Delle Marche, Ospedali Riuniti, Ancona, Italy;4. Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy;1. Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan;2. Department of Pathology, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan;1. Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan;2. Department of Surgery, Kashiwara Municipal Hospital, Osaka, Japan;3. Department of Plastic and Reconstructive Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan;4. Department of Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan;5. Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan;1. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan;1. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, España;2. Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, España |
| Abstract: | IntroductionThis study aimed to determine the impact of FOLFIRINOX neoadjuvant therapy on patients with non-metastatic borderline/locally advanced (BL/LA) pancreatic ductal adenocarcinoma (PDAC), in current practice.Material and methodsFrom 2010 to 2017, 258 patients with BL/LA PDAC from a single high-volume institution received FOLFIRINOX neoadjuvant treatment.ResultsThe 258 patients received a median number of 6 cycles of FOLFIRINOX (range, 3–16); 98 (38%) patients underwent curative surgery, and 160 (62%) continued medical treatment. A venous resection was performed in 57 patients (58%), and an arterial resection in 12 (12%). The postoperative 30- and 90-day mortality rates were 6.1% and 8.2%, respectively. Adjuvant chemotherapy was performed in 57 patients (59%). The median overall survival (OS) in patients who did (n = 98) or did not (n = 160) undergo surgical resection were 39 months and 19 months, respectively (P < 0.001). In resected patients, the ASA 3 score (P < 0.01), venous resection (P < 0.01), hemorrhage (P < 0.01), and R1 margin status (P = 0.03) were found to negatively influence the OS. The median OS was significantly higher in patients who did not require a venous resection (not reached vs. 26.5 months, P < 0.001).ConclusionsNeoadjuvant FOLFIRINOX provided a survival benefit in BL/LA PDAC patients, particularly in those who did not ultimately require venous resection. |
