Impact of early disease progression and surgical complications on adjuvant chemotherapy completion rates and survival in patients undergoing the surgery first approach for resectable pancreatic ductal adenocarcinoma – A population-based cohort study

Labori, Knut Jørgen; Katz, Matthew H.; Tzeng, Ching Wei D.; Bjørnbeth, Bjørn Atle; Cvancarova, Milada; Edwin, Bjørn; Kure, Elin H.; Eide, T. J.; Dueland, Svein; Buanes, Trond; Gladhaug, Ivar P.

doi:10.3109/0284186x.2015.1068445

Cited by 137 publications

(102 citation statements)

References 39 publications

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“…A recent study reported a median survival of 29·7 months for patients who underwent pancreatoduodenectomy with venous resection and received adjuvant chemotherapy. This is considerably better than results from other centres, in which median survival rates ranged from 15 to 25 months following venous resection for pancreatic cancer. Interestingly, Murakami and colleagues reported a very high frequency of patients undergoing venous resection during pancreatoduodenectomy in their study population (46·6 per cent of those included); however, only 60 per cent of the patients had true tumour invasion of the superior mesenteric–portal vein wall.…”

Section: Discussionmentioning

confidence: 67%

Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy

Kleive

Sahakyan

Berstad

et al. 2017

British Journal of Surgery

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Section: Discussionmentioning

confidence: 67%

Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy

Kleive

Sahakyan

Berstad

et al. 2017

British Journal of Surgery

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“…5,6 Morbidity after surgery is not uncommon in elderly patients and may cause omission of chemotherapy. 25,26,35 Unfortunately, these data were not available in the present study. No distinction was made between neo-and adjuvant chemotherapy because NOR did not provide this.…”

Section: Discussionmentioning

confidence: 89%

Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

Groen

Douwes

Eycken³

et al. 2020

Ann Surg Oncol

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Background. Elderly patients with pancreatic cancer are underrepresented in clinical trials, resulting in a lack of evidence. Objective. The aim of this study was to compare treatment and overall survival (OS) of patients aged C 70 years with stage I-II pancreatic cancer in the EURECCA Pancreas Consortium.Methods. This was an observational cohort study of the Belgian (BE), Dutch (NL), and Norwegian (NOR) cancer registries. The primary outcome was OS, while secondary outcomes were resection, 90-day mortality after resection, and (neo)adjuvant and palliative chemotherapy.Previous communication This work was presented as a 'poster in the spotlight' at the 39th

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“…Neoadjuvant chemotherapy has been advocated in patients with resectable tumors to secure completion of systemic treatment[15] which may be precluded by postoperative complications or early disease progression after upfront surgery[16]. The net result of neoadjuvance is selection of patients with favorable tumor biology for subsequent resection.…”

Section: Primary Resectable Tumorsmentioning

confidence: 99%

Role of surgery in pancreatic cancer

Buanes

2017

WJG

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Treatment of pancreatic cancer is multimodal and surgery is an essential part, mandatory for curative potential. Also chemotherapy is essential, and serious postoperative complications or rapid disease progression may preclude completion of multimodal treatment. The sequence of treatment interventions has therefore become an important concern, and numerous ongoing randomized controlled trials compare clinical outcome after upfront surgery and neoadjuvant treatment with subsequent resection. In previous years, borderline resectable and locally advanced pancreatic cancer was most often considered unresectable. More effective chemotherapy together with the latest improvements in surgical expertise has resulted in extended operations, pushing the borders of resectability. Multivisceral resections with or without resection of major mesenteric vessels are now performed in numerous patients, resulting in better outcome, recorded as overall survival and/or patient reported outcome. But postoperative morbidity increases concurrently, and clinical benefit must be carefully evaluated against risk of potential harm, associated with new comprehensive multimodal treatment sequences. Even though cost/utility analyses are deficient, extended surgery has resulted in significantly longer and better life for many patients with no other treatment alternative. Improved selection of patients to surgery and/or chemotherapy will in the near future be possible, based on better tumor biology insight. Clinically available biomarkers enabling personalized treatment are forthcoming, but these options are still limited. The importance of surgical resection for each patient’s prognosis is presently increasing, justifying sustained expansion of the surgical treatment modality.

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Impact of early disease progression and surgical complications on adjuvant chemotherapy completion rates and survival in patients undergoing the surgery first approach for resectable pancreatic ductal adenocarcinoma – A population-based cohort study

Cited by 137 publications

References 39 publications

Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy

Trends in indications, complications and outcomes for venous resection during pancreatoduodenectomy

Treatment and Survival of Elderly Patients with Stage I–II Pancreatic Cancer: A Report of the EURECCA Pancreas Consortium

Role of surgery in pancreatic cancer

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