The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study
Background: Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositorio: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:iibsantpau.fundanetsuite.com:p19960 |
| Acceso en línea: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19960 |
| Access Level: | acceso abierto |
| Palabra clave: | pancreatic adenocarcinoma pancreatic body/tail resectable neoadjuvant therapy CA19-9 tumor size |
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| dc.title.none.fl_str_mv |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| title |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| spellingShingle |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study Rangelova, E pancreatic adenocarcinoma pancreatic body/tail resectable neoadjuvant therapy CA19-9 tumor size |
| title_short |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| title_full |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| title_fullStr |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| title_full_unstemmed |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| title_sort |
The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study |
| dc.creator.none.fl_str_mv |
Rangelova, E Stoop, TF van Ramshorst, TME Ali, M van Bodegraven, EA Javed, AA Hashimoto, D Steyerberg, E Banerjee, A Jain, A Sauvanet, A Serrablo, A Giani, A Giardino, A Zerbi, A Arshad, A Wijma, AG Coratti, A Zironda, A Socratous, A Rojas, A Halimi, A Ejaz, A Oba, A Patel, BY Björnsson, B Reames, BN Tingstedt, B Goh, BKP Payá-Llorente, C Del Pozo, CD González-Abós, C Medin, C van Eijck, CHJ de Ponthaud, C Takishita, C Schwabl, C Månsson, C Ricci, C Thiels, CA Douchi, D Hughes, DL Kilburn, D Flanking, D Kleive, D Silva, DS Edil, BH Pando, E Moltzer, E Kauffman, EF Warren, E Bozkurt, E Sparrelid, E Thoma, E Verkolf, E Ausania, F Giannone, F Hüttner, FJ Burdio, F Souche, FR Berrevoet, F Daams, F Motoi, F Saliba, G Kazemier, G Roeyen, G Nappo, G Butturini, G Ferrari, G Fusai, GK Honda, G Sergeant, G Karteszi, H Takami, H Suto, H Matsumoto, I Mora-Oliver, I Frigerio, I Fabre, JM Chen, J Sham, JG Davide, J Urdzik, J de Martino, J Nielsen, K Okano, K Kamei, K Okada, K Tanaka, K Labori, KJ Goodsell, KE Alberici, L Webber, L Kirkov, L de Franco, L Miyashita, M Maglione, M Gramellini, M Ramera, M Amaral, MJ Ramaekers, M Truty, MJ van Dam, MA Stommel, MWJ Petrikowski, M Imamura, M Hayashi, M D'Hondt, M Brunner, M Hogg, ME Zhang, C Suárez-Muñoz, MA Luyer, MD Unno, M Mizuma, M Janot, M Sahakyan, MA Jamieson, NB Busch, OR Bilge, O Belyaev, O Franklin, O Sánchez-Velázquez, P Pessaux, P Holka, PS Ghorbani, P Casadei, R Sartoris, R Schulick, RD Grützmann, R Sutcliffe, R Mata, R Patel, RB Takahashi, R Franco, SR Cabús, SS Hirano, S Gaujoux, S Festen, S Kozono, S Maithel, SK Chai, SM Yamaki, S van Laarhoven, S Mieog, JSD Murakami, T Codjia, T Sumiyoshi, T Karsten, TM Nakamura, T Sugawara, T Boggi, U Hartman, V de Meijer, VE Bartholomä, W Kwon, W Koh, YX Cho, Y Takeyama, Y Inoue, Y Nagakawa, Y Kawamoto, Y Ome, Y Soonawalla, Z Uemura, K Wolfgang, CL Jang, JY Padbury, R Satoi, S Messersmith, W Wilmink, JW Abu Hilal, M Besselink, MG Del Chiaro, M |
| author |
Rangelova, E |
| author_facet |
Rangelova, E Stoop, TF van Ramshorst, TME Ali, M van Bodegraven, EA Javed, AA Hashimoto, D Steyerberg, E Banerjee, A Jain, A Sauvanet, A Serrablo, A Giani, A Giardino, A Zerbi, A Arshad, A Wijma, AG Coratti, A Zironda, A Socratous, A Rojas, A Halimi, A Ejaz, A Oba, A Patel, BY Björnsson, B Reames, BN Tingstedt, B Goh, BKP Payá-Llorente, C Del Pozo, CD González-Abós, C Medin, C van Eijck, CHJ de Ponthaud, C Takishita, C Schwabl, C Månsson, C Ricci, C Thiels, CA Douchi, D Hughes, DL Kilburn, D Flanking, D Kleive, D Silva, DS Edil, BH Pando, E Moltzer, E Kauffman, EF Warren, E Bozkurt, E Sparrelid, E Thoma, E Verkolf, E Ausania, F Giannone, F Hüttner, FJ Burdio, F Souche, FR Berrevoet, F Daams, F Motoi, F Saliba, G Kazemier, G Roeyen, G Nappo, G Butturini, G Ferrari, G Fusai, GK Honda, G Sergeant, G Karteszi, H Takami, H Suto, H Matsumoto, I Mora-Oliver, I Frigerio, I Fabre, JM Chen, J Sham, JG Davide, J Urdzik, J de Martino, J Nielsen, K Okano, K Kamei, K Okada, K Tanaka, K Labori, KJ Goodsell, KE Alberici, L Webber, L Kirkov, L de Franco, L Miyashita, M Maglione, M Gramellini, M Ramera, M Amaral, MJ Ramaekers, M Truty, MJ van Dam, MA Stommel, MWJ Petrikowski, M Imamura, M Hayashi, M D'Hondt, M Brunner, M Hogg, ME Zhang, C Suárez-Muñoz, MA Luyer, MD Unno, M Mizuma, M Janot, M Sahakyan, MA Jamieson, NB Busch, OR Bilge, O Belyaev, O Franklin, O Sánchez-Velázquez, P Pessaux, P Holka, PS Ghorbani, P Casadei, R Sartoris, R Schulick, RD Grützmann, R Sutcliffe, R Mata, R Patel, RB Takahashi, R Franco, SR Cabús, SS Hirano, S Gaujoux, S Festen, S Kozono, S Maithel, SK Chai, SM Yamaki, S van Laarhoven, S Mieog, JSD Murakami, T Codjia, T Sumiyoshi, T Karsten, TM Nakamura, T Sugawara, T Boggi, U Hartman, V de Meijer, VE Bartholomä, W Kwon, W Koh, YX Cho, Y Takeyama, Y Inoue, Y Nagakawa, Y Kawamoto, Y Ome, Y Soonawalla, Z Uemura, K Wolfgang, CL Jang, JY Padbury, R Satoi, S Messersmith, W Wilmink, JW Abu Hilal, M Besselink, MG Del Chiaro, M |
| author_role |
author |
| author2 |
Stoop, TF van Ramshorst, TME Ali, M van Bodegraven, EA Javed, AA Hashimoto, D Steyerberg, E Banerjee, A Jain, A Sauvanet, A Serrablo, A Giani, A Giardino, A Zerbi, A Arshad, A Wijma, AG Coratti, A Zironda, A Socratous, A Rojas, A Halimi, A Ejaz, A Oba, A Patel, BY Björnsson, B Reames, BN Tingstedt, B Goh, BKP Payá-Llorente, C Del Pozo, CD González-Abós, C Medin, C van Eijck, CHJ de Ponthaud, C Takishita, C Schwabl, C Månsson, C Ricci, C Thiels, CA Douchi, D Hughes, DL Kilburn, D Flanking, D Kleive, D Silva, DS Edil, BH Pando, E Moltzer, E Kauffman, EF Warren, E Bozkurt, E Sparrelid, E Thoma, E Verkolf, E Ausania, F Giannone, F Hüttner, FJ Burdio, F Souche, FR Berrevoet, F Daams, F Motoi, F Saliba, G Kazemier, G Roeyen, G Nappo, G Butturini, G Ferrari, G Fusai, GK Honda, G Sergeant, G Karteszi, H Takami, H Suto, H Matsumoto, I Mora-Oliver, I Frigerio, I Fabre, JM Chen, J Sham, JG Davide, J Urdzik, J de Martino, J Nielsen, K Okano, K Kamei, K Okada, K Tanaka, K Labori, KJ Goodsell, KE Alberici, L Webber, L Kirkov, L de Franco, L Miyashita, M Maglione, M Gramellini, M Ramera, M Amaral, MJ Ramaekers, M Truty, MJ van Dam, MA Stommel, MWJ Petrikowski, M Imamura, M Hayashi, M D'Hondt, M Brunner, M Hogg, ME Zhang, C Suárez-Muñoz, MA Luyer, MD Unno, M Mizuma, M Janot, M Sahakyan, MA Jamieson, NB Busch, OR Bilge, O Belyaev, O Franklin, O Sánchez-Velázquez, P Pessaux, P Holka, PS Ghorbani, P Casadei, R Sartoris, R Schulick, RD Grützmann, R Sutcliffe, R Mata, R Patel, RB Takahashi, R Franco, SR Cabús, SS Hirano, S Gaujoux, S Festen, S Kozono, S Maithel, SK Chai, SM Yamaki, S van Laarhoven, S Mieog, JSD Murakami, T Codjia, T Sumiyoshi, T Karsten, TM Nakamura, T Sugawara, T Boggi, U Hartman, V de Meijer, VE Bartholomä, W Kwon, W Koh, YX Cho, Y Takeyama, Y Inoue, Y Nagakawa, Y Kawamoto, Y Ome, Y Soonawalla, Z Uemura, K Wolfgang, CL Jang, JY Padbury, R Satoi, S Messersmith, W Wilmink, JW Abu Hilal, M Besselink, MG Del Chiaro, M |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
pancreatic adenocarcinoma pancreatic body/tail resectable neoadjuvant therapy CA19-9 tumor size |
| topic |
pancreatic adenocarcinoma pancreatic body/tail resectable neoadjuvant therapy CA19-9 tumor size |
| description |
Background: Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients with right-sided RPC. The purpose of this study was to assess the association between neoadjuvant therapy and OS in patients with left-sided RPC compared with upfront surgery. Patients and methods: This was an international multicenter retrospective study including consecutive patients after left-sided pancreatic resection for pathology-proven RPC, either after neoadjuvant therapy or upfront surgery in 76 centers from 18 countries on 4 continents (2013-2019). The primary endpoint was OS from diagnosis. Time-dependent Cox regression analysis was carried out to investigate the association of neoadjuvant therapy with OS, adjusting for confounders at the time of diagnosis. Adjusted OS probabilities were calculated. Results: Overall, 2282 patients after left-sided pancreatic resection for RPC were included of whom 290 patients (13%) received neoadjuvant therapy. The most common neoadjuvant regimens were (m)FOLFIRINOX (38%) and gemcitabine-nab-paclitaxel (22%). After upfront surgery, 72% of patients received adjuvant chemotherapy, mostly a single-agent regimen (74%). Neoadjuvant therapy was associated with prolonged OS compared with upfront surgery (adjusted hazard ratio 0.69, 95% confidence interval 0.58-0.83) with an adjusted median OS of 53 versus 37 months (P = 0.0003) and adjusted 5-year OS rates of 47% versus 35% (P = 0.0001) compared with upfront surgery. Interaction analysis demonstrated a stronger effect of neoadjuvant therapy in patients with a larger tumor (P-interaction = 0.003) and higher serum carbohydrate antigen 19-9 (CA19-9; P-interaction = 0.005). In contrast, the effect of neoadjuvant therapy was not enhanced for splenic artery (P-interaction = 0.43), splenic vein (P-interaction = 0.30), retroperitoneal (P-interaction = 0.84), and multivisceral (P-interaction = 0.96) involvement. Conclusions: Neoadjuvant therapy in patients with left-sided RPC was associated with improved OS compared with upfront surgery. The impact of neoadjuvant therapy increased with larger tumor size and higher serum CA19-9 at diagnosis. Randomized controlled trials on neoadjuvant therapy specifically in patients with left-sided RPC are needed. |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19960 |
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https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19960 |
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Inglés |
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Inglés |
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info:eu-repo/semantics/openAccess |
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openAccess |
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ELSEVIER |
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ELSEVIER |
| dc.source.none.fl_str_mv |
ANNALS OF ONCOLOGY ISSN: 09237534 ISSNe: 15698041 reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
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r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
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1869423376876961792 |
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The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter studyRangelova, EStoop, TFvan Ramshorst, TMEAli, Mvan Bodegraven, EAJaved, AAHashimoto, DSteyerberg, EBanerjee, AJain, ASauvanet, ASerrablo, AGiani, AGiardino, AZerbi, AArshad, AWijma, AGCoratti, AZironda, ASocratous, ARojas, AHalimi, AEjaz, AOba, APatel, BYBjörnsson, BReames, BNTingstedt, BGoh, BKPPayá-Llorente, CDel Pozo, CDGonzález-Abós, CMedin, Cvan Eijck, CHJde Ponthaud, CTakishita, CSchwabl, CMånsson, CRicci, CThiels, CADouchi, DHughes, DLKilburn, DFlanking, DKleive, DSilva, DSEdil, BHPando, EMoltzer, EKauffman, EFWarren, EBozkurt, ESparrelid, EThoma, EVerkolf, EAusania, FGiannone, FHüttner, FJBurdio, FSouche, FRBerrevoet, FDaams, FMotoi, FSaliba, GKazemier, GRoeyen, GNappo, GButturini, GFerrari, GFusai, GKHonda, GSergeant, GKarteszi, HTakami, HSuto, HMatsumoto, IMora-Oliver, IFrigerio, IFabre, JMChen, JSham, JGDavide, JUrdzik, Jde Martino, JNielsen, KOkano, KKamei, KOkada, KTanaka, KLabori, KJGoodsell, KEAlberici, LWebber, LKirkov, Lde Franco, LMiyashita, MMaglione, MGramellini, MRamera, MAmaral, MJRamaekers, MTruty, MJvan Dam, MAStommel, MWJPetrikowski, MImamura, MHayashi, MD'Hondt, MBrunner, MHogg, MEZhang, CSuárez-Muñoz, MALuyer, MDUnno, MMizuma, MJanot, MSahakyan, MAJamieson, NBBusch, ORBilge, OBelyaev, OFranklin, OSánchez-Velázquez, PPessaux, PHolka, PSGhorbani, PCasadei, RSartoris, RSchulick, RDGrützmann, RSutcliffe, RMata, RPatel, RBTakahashi, RFranco, SRCabús, SSHirano, SGaujoux, SFesten, SKozono, SMaithel, SKChai, SMYamaki, Svan Laarhoven, SMieog, JSDMurakami, TCodjia, TSumiyoshi, TKarsten, TMNakamura, TSugawara, TBoggi, UHartman, Vde Meijer, VEBartholomä, WKwon, WKoh, YXCho, YTakeyama, YInoue, YNagakawa, YKawamoto, YOme, YSoonawalla, ZUemura, KWolfgang, CLJang, JYPadbury, RSatoi, SMessersmith, WWilmink, JWAbu Hilal, MBesselink, MGDel Chiaro, Mpancreatic adenocarcinomapancreatic body/tailresectableneoadjuvant therapyCA19-9tumor sizeBackground: Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients with right-sided RPC. The purpose of this study was to assess the association between neoadjuvant therapy and OS in patients with left-sided RPC compared with upfront surgery. Patients and methods: This was an international multicenter retrospective study including consecutive patients after left-sided pancreatic resection for pathology-proven RPC, either after neoadjuvant therapy or upfront surgery in 76 centers from 18 countries on 4 continents (2013-2019). The primary endpoint was OS from diagnosis. Time-dependent Cox regression analysis was carried out to investigate the association of neoadjuvant therapy with OS, adjusting for confounders at the time of diagnosis. Adjusted OS probabilities were calculated. Results: Overall, 2282 patients after left-sided pancreatic resection for RPC were included of whom 290 patients (13%) received neoadjuvant therapy. The most common neoadjuvant regimens were (m)FOLFIRINOX (38%) and gemcitabine-nab-paclitaxel (22%). After upfront surgery, 72% of patients received adjuvant chemotherapy, mostly a single-agent regimen (74%). Neoadjuvant therapy was associated with prolonged OS compared with upfront surgery (adjusted hazard ratio 0.69, 95% confidence interval 0.58-0.83) with an adjusted median OS of 53 versus 37 months (P = 0.0003) and adjusted 5-year OS rates of 47% versus 35% (P = 0.0001) compared with upfront surgery. Interaction analysis demonstrated a stronger effect of neoadjuvant therapy in patients with a larger tumor (P-interaction = 0.003) and higher serum carbohydrate antigen 19-9 (CA19-9; P-interaction = 0.005). In contrast, the effect of neoadjuvant therapy was not enhanced for splenic artery (P-interaction = 0.43), splenic vein (P-interaction = 0.30), retroperitoneal (P-interaction = 0.84), and multivisceral (P-interaction = 0.96) involvement. Conclusions: Neoadjuvant therapy in patients with left-sided RPC was associated with improved OS compared with upfront surgery. The impact of neoadjuvant therapy increased with larger tumor size and higher serum CA19-9 at diagnosis. Randomized controlled trials on neoadjuvant therapy specifically in patients with left-sided RPC are needed.ELSEVIER2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19960ANNALS OF ONCOLOGYISSN: 09237534ISSNe: 15698041reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p199602026-06-14T12:41:47Z |
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15,812455 |