Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer: A multicenter prospective cohort

Autor: Christiaan van der Leij, Krijn P. van Lienden, Jan J. J. de Vries, Nomdo S Renken, F. Daams, Ronald M. van Dam, C. Yung Nio, M. Liem, Thomas L. Bollen, Geert-Jan Creemers, Steffi J Rombouts, Judith de Vos-Geelen, Gijs A. Patijn, Maartje Los, Sebastiaan Festen, I. Quintus Molenaar, J. Nederend, Derk Jan A. de Groot, Rutger C G Bruijnen, Jan Willem B. de Groot, Joost G Blomjous, Leonie J. M. Mekenkamp, John J. Hermans, Nadia Haj Mohammad, Ignace H. J. T. de Hingh, Susana I S Patuleia, Johanna W. Wilmink, Thijs J Schouten, Maaike E Verweij, Lilly J H Brada, Hjalmar C. van Santvoort, Emile D. Kerver, Vincent E de Meijer, J.F.M. Pruijt, Annelie Vulink, Koop Bosscha, Frank J. Wessels, Maarten S. van Leeuwen, Marc G. Besselink, Marco B. Polee, Olivier R. Busch, Martijn R. Meijerink, M.S. Walma, Martijn W J Stommel
Přispěvatelé: Surgery, RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Heelkunde (9), MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and nuclear medicine, CCA - Cancer biology and immunology, Ophthalmology, Internal medicine, VU University medical center, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and Nuclear Medicine, Oncology, Groningen Institute for Organ Transplantation (GIOT), Center for Liver, Digestive and Metabolic Diseases (CLDM), Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Rok vydání: 2021
Předmět:
Male
Antimetabolites
Antineoplastic
medicine.medical_specialty
Paclitaxel
FOLFIRINOX
medicine.medical_treatment
Locally advanced pancreatic cancer
Leucovorin
Adenocarcinoma
Irinotecan
Deoxycytidine
Cohort Studies
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
All institutes and research themes of the Radboud University Medical Center
Pancreatectomy
Albumins
Internal medicine
Pancreatic cancer
treatment strategies
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Prospective Studies
Prospective cohort study
Response Evaluation Criteria in Solid Tumors
Aged
Chemotherapy
business.industry
General Medicine
Middle Aged
medicine.disease
Gemcitabine
Neoadjuvant Therapy
Oxaliplatin
Pancreatic Neoplasms
Survival Rate
Oncology
Cohort
Treatment strategy
Female
Surgery
Fluorouracil
business
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
medicine.drug
Zdroj: European Journal of Surgical Oncology, 47(3), 699-707. ELSEVIER SCI LTD
European Journal of Surgical Oncology, 47(3), 699-707. W.B. Saunders Ltd
for the Dutch Pancreatic Cancer Group 2021, ' Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer : A multicenter prospective cohort ', European Journal of Surgical Oncology, vol. 47, no. 3, pp. 699-707 . https://doi.org/10.1016/j.ejso.2020.11.137
European Journal of Surgical Oncology, 47, 699-707
European journal of surgical oncology, 47(3), 699-707. W.B. Saunders Ltd
European Journal of Surgical Oncology, 47, 3, pp. 699-707
ISSN: 0748-7983
DOI: 10.1016/j.ejso.2020.11.137
Popis: Introduction: Since current studies on locally advanced pancreatic cancer (LAPC) mainly report from single, high-volume centers, it is unclear if outcomes can be translated to daily clinical practice. This study provides treatment strategies and clinical outcomes within a multicenter cohort of unselected patients with LAPC.Materials and methods: Consecutive patients with LAPC according to Dutch Pancreatic Cancer Group criteria, were prospectively included in 14 centers from April 2015 until December 2017. A centralized expert panel reviewed response according to RECIST v1.1 and potential surgical resectability. Primary outcome was median overall survival (mOS), stratified for primary treatment strategy.Results: Overall, 422 patients were included, of whom 77% (n = 326) received chemotherapy. The majority started with FOLFIRINOX (77%, 252/326) with a median of six cycles (IQR 4-10). Gemcitabine monotherapy was given to 13% (41/326) of patients and nab-paclitaxel/gemcitabine to 10% (33/326), with a median of two (IQR 3-5) and three (IQR 3-5) cycles respectively. The mOS of the entire cohort was 10 months (95%CI 9-11). In patients treated with FOLFIRINOX, gemcitabine monotherapy, or nab-paclitaxel/gemcitabine, mOS was 14 (95%CI 13-15), 9 (95%CI 8-10), and 9 months (95%CI 8-10), respectively. A resection was performed in 13% (32/252) of patients after FOLFIRINOX, resulting in a mOS of 23 months (95%CI 12-34).Conclusion: This multicenter unselected cohort of patients with LAPC resulted in a 14 month mOS and a 13% resection rate after FOLFIRINOX. These data put previous results in perspective, enable us to inform patients with more accurate survival numbers and will support decision-making in clinical practice. (C) 2020 The Authors. Published by Elsevier Ltd.
Databáze: OpenAIRE
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