Surgical patterns of care of pancreatic cancer. A French population-based study.

Autor: Goebel G; Surgical Oncology Department, Centre Georges François Leclerc, Dijon, France., Jooste V; Digestive Cancer Registry of Burgundy, Dijon, France; French Network of Cancer Registries (FRANCIM), France; Dijon University Hospital, Dijon, France; INSERM UMR 1231, EPICAD, Dijon, France; Université de Bourgogne, Dijon, France., Molinie F; French Network of Cancer Registries (FRANCIM), France; Loire-Atlantique/Vendée Cancer Registry, SIRIC-ILIAD, Nantes, France; CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France., Grosclaude P; French Network of Cancer Registries (FRANCIM), France; CERPOP, UMR 1295, Université de Toulouse III, Toulouse, France; Tarn Cancers Registry, Claudius Regaud Institute, Toulouse University Cancer Institute (IUCT- O), Toulouse, France., Woronoff AS; French Network of Cancer Registries (FRANCIM), France; Doubs Cancer Registry, Besançon University Hospital, Besançon, France; Research Unit EA3181, Franche-Comté University, Besançon, France., Alves A; French Network of Cancer Registries (FRANCIM), France; Calvados Digestive Cancer Registry, University Hospital Centre, Caen, France; ANTICIPE U1086 INSERM-UCN, Centre François Baclesse, Normandie UNICAEN University, Caen, France., Bouvier V; French Network of Cancer Registries (FRANCIM), France; Calvados Digestive Cancer Registry, University Hospital Centre, Caen, France; ANTICIPE U1086 INSERM-UCN, Centre François Baclesse, Normandie UNICAEN University, Caen, France., Nousbaum JB; French Network of Cancer Registries (FRANCIM), France; Registre des Cancers Digestifs Du Finistère, 29609, Brest, France; EA7479 SPURBO, Université de Bretagne Occidentale, 29200, Brest, France; CHRU Brest, Service D'Hépato-gastro-entérologie, 29200, Brest, France., Plouvier S; French Network of Cancer Registries (FRANCIM), France; General Cancer Registry of Lille Area, C2RC, Lille, France., Bengrine-Lefevre L; Medical Oncology Department, UCOG Bourgogne, Centre Georges François Leclerc, Dijon, France., Rabel T; Surgical Oncology Department, Centre Georges François Leclerc, Dijon, France., Bouvier AM; Digestive Cancer Registry of Burgundy, Dijon, France; French Network of Cancer Registries (FRANCIM), France; Dijon University Hospital, Dijon, France; INSERM UMR 1231, EPICAD, Dijon, France; Université de Bourgogne, Dijon, France. Electronic address: anne-marie.bouvier@u-bourgogne.fr.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Oct 09, pp. 108748. Date of Electronic Publication: 2024 Oct 09.
DOI: 10.1016/j.ejso.2024.108748
Abstrakt: Introduction: Surgical resection is the standard recommended treatment in localized pancreatic cancer. The benefit of neoadjuvant chemotherapy is still debated. The aim of this population-based study was to describe the pancreatic cancer surgical management.
Material and Methods: An observational real-world study from the French Network of Cancer Registries sampled 638 pancreatic adenocarcinomas diagnosed in 2019. Characteristics of patients, tumours and recommended and administered treatments were collected. Operability of the patients and resectability of the tumours were described. A multivariate logistic regression was used to identify factors associated with the probability of having surgical resection.
Results: Among the 263 (41 %) patients with M0 pancreatic adenocarcinomas, 202 patients (77 %) were considered operable and 157 (60 %) also had a tumour considered resectable. Upfront resection was recommended for 68 % and resection after neoadjuvant chemotherapy for 32 % of these patients. Among operable patients with resectable tumour, 36 % underwent upfront R0 resection, and 15 % achieved R0 resection following neoadjuvant chemotherapy. Eventually, among M0 pancreatic adenocarcinomas, age over 80 years (OR ≥80 years vs < 65 years : 0.16 [0.06-0.39], p < 0.001) and WHO performance status over 0 (OR 1-2 vs 0 : 0.43 [0.24-0.79], p = 0.013) decreased the odds of having resection. R0 surgical resection was achieved in 61 % of patients selected for upfront surgical recommendation, and 29 % of those selected for a prior neoadjuvant chemotherapy.
Conclusion: In a non-selected population, one-third of patients with localized pancreatic cancer had a complete R0 surgical resection. Neoadjuvant chemotherapy did not achieve a resection rate similar to that of patients selected for upfront surgical indication.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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