Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer
BackgroundOncologic outcomes of conversion surgery for advanced pancreatic cancer (PC) have scarcely been reported. Therefore, this study aimed to investigate the outcomes of conversion surgery with preoperative treatment of FOLFIRINOX or gemcitabine with nab-paclitaxel (GnP) for patients with advan...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1510016/full |
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| author | Yoon Suk Lee Jang Won Lee Hak Jun Kim Jung Won Chun Jong-Chan Lee Dong Kee Jang Jin-Hyeok Hwang Young Ae Kim Sang Myung Woo |
| author_facet | Yoon Suk Lee Jang Won Lee Hak Jun Kim Jung Won Chun Jong-Chan Lee Dong Kee Jang Jin-Hyeok Hwang Young Ae Kim Sang Myung Woo |
| author_sort | Yoon Suk Lee |
| collection | DOAJ |
| description | BackgroundOncologic outcomes of conversion surgery for advanced pancreatic cancer (PC) have scarcely been reported. Therefore, this study aimed to investigate the outcomes of conversion surgery with preoperative treatment of FOLFIRINOX or gemcitabine with nab-paclitaxel (GnP) for patients with advanced PC including locally advanced or metastatic PC.MethodsUsing the National Health Insurance database between 2005 and 2020, we identified patients who underwent conversion surgery after chemotherapy with FOLFIRINOX or GnP for advanced PC. The patients were categorized based on preoperative treatment. Survival outcomes were evaluated based on the date of cancer diagnosis and conversion surgery.ResultsAmong 69,183 patients with advanced PC, 476 underwent conversion surgery; 430 with FOLFIRINOX and 46 with GnP. The median duration from diagnosis to conversion surgery was 6.4 months. Overall survival (OS) was 31.2 months after cancer diagnosis and 23.5 months after conversion surgery. Adjuvant chemotherapy was a significant factor for OS, with hazard ratios (HRs) of 0.23 [95% CI 0.12–0.44, P < 0.01] from cancer diagnosis and 0.20 [95% CI 0.10–0.37, P < 0.01] from conversion surgery. No significant differences were noted between FOLFIRINOX and GnP. However, maintaining the same regimens as preoperative chemotherapy was a significant factor, with HRs of 0.67 [95% CI 0.47–0.95, P = 0.02] from cancer diagnosis and 0.69 [95% CI 0.49–0.98, P = 0.04] from conversion surgery.ConclusionsThe incorporation of adjuvant chemotherapy with the same preoperative regimen could be an effective strategy for patients with advanced PC who would undergo conversion surgery. |
| format | Article |
| id | doaj-art-8cef4f729ba541e29969ab18c5cf4c3c |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-8cef4f729ba541e29969ab18c5cf4c3c2025-01-07T05:23:46ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011410.3389/fonc.2024.15100161510016Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancerYoon Suk Lee0Jang Won Lee1Hak Jun Kim2Jung Won Chun3Jong-Chan Lee4Dong Kee Jang5Jin-Hyeok Hwang6Young Ae Kim7Sang Myung Woo8Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of KoreaDivision of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of KoreaDepartment of Artificial Intelligence Convergence, Hallym University Graduate School, Chuncheon, Republic of KoreaResearch Institute, Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Republic of KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of KoreaDepartment of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of KoreaDivision of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of KoreaResearch Institute, Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Republic of KoreaBackgroundOncologic outcomes of conversion surgery for advanced pancreatic cancer (PC) have scarcely been reported. Therefore, this study aimed to investigate the outcomes of conversion surgery with preoperative treatment of FOLFIRINOX or gemcitabine with nab-paclitaxel (GnP) for patients with advanced PC including locally advanced or metastatic PC.MethodsUsing the National Health Insurance database between 2005 and 2020, we identified patients who underwent conversion surgery after chemotherapy with FOLFIRINOX or GnP for advanced PC. The patients were categorized based on preoperative treatment. Survival outcomes were evaluated based on the date of cancer diagnosis and conversion surgery.ResultsAmong 69,183 patients with advanced PC, 476 underwent conversion surgery; 430 with FOLFIRINOX and 46 with GnP. The median duration from diagnosis to conversion surgery was 6.4 months. Overall survival (OS) was 31.2 months after cancer diagnosis and 23.5 months after conversion surgery. Adjuvant chemotherapy was a significant factor for OS, with hazard ratios (HRs) of 0.23 [95% CI 0.12–0.44, P < 0.01] from cancer diagnosis and 0.20 [95% CI 0.10–0.37, P < 0.01] from conversion surgery. No significant differences were noted between FOLFIRINOX and GnP. However, maintaining the same regimens as preoperative chemotherapy was a significant factor, with HRs of 0.67 [95% CI 0.47–0.95, P = 0.02] from cancer diagnosis and 0.69 [95% CI 0.49–0.98, P = 0.04] from conversion surgery.ConclusionsThe incorporation of adjuvant chemotherapy with the same preoperative regimen could be an effective strategy for patients with advanced PC who would undergo conversion surgery.https://www.frontiersin.org/articles/10.3389/fonc.2024.1510016/fullsurgical proceduresoperativeFOLFIRINOXalbumin-bounded paclitaxelcarcinomapancreatic ductal |
| spellingShingle | Yoon Suk Lee Jang Won Lee Hak Jun Kim Jung Won Chun Jong-Chan Lee Dong Kee Jang Jin-Hyeok Hwang Young Ae Kim Sang Myung Woo Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer Frontiers in Oncology surgical procedures operative FOLFIRINOX albumin-bounded paclitaxel carcinoma pancreatic ductal |
| title | Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| title_full | Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| title_fullStr | Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| title_full_unstemmed | Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| title_short | Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| title_sort | survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer |
| topic | surgical procedures operative FOLFIRINOX albumin-bounded paclitaxel carcinoma pancreatic ductal |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1510016/full |
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