RT Journal Article
SR Electronic
T1 Conversion Surgery for Unresectable Pancreatic Cancer Treated With FOLFIRINOX or Gemcitabine Plus Nab-paclitaxel
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 1817
OP 1826
DO 10.21873/anticanres.16335
VO 43
IS 4
A1 YASUSHI IDE
A1 TAIGA OTSUKA
A1 MOTOTSUGU SHIMOKAWA
A1 FUTA KOGA
A1 YUJIRO UEDA
A1 JUNICHI NAKAZAWA
A1 AZUSA KOMORI
A1 SATOSHI OTSU
A1 SHIHO ARIMA
A1 MASARU FUKAHORI
A1 AKITAKA MAKIYAMA
A1 YUDAI SHINOHARA
A1 SHOHEI UENO
A1 HIROKI TAGUCHI
A1 TAKUYA HONDA
A1 TARO SHIBUKI
A1 KENTA NIO
A1 NORIO URESHINO
A1 TOSHIHIKO MIZUTA
A1 KENJI MITSUGI
A1 TSUYOSHI SHIRAKAWA
YR 2023
UL http://ar.iiarjournals.org/content/43/4/1817.abstract
AB Background/Aim: Recent advances in chemotherapy have made significant progress in conversion surgery (CS) for unresectable pancreatic cancer (uPC). However, the success rate and efficacy of CS have not been fully demonstrated in patients with uPC treated with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP). Patients and Methods: We retrospectively reviewed the records of 318 patients with uPC who received FFX or GnP as first-line chemotherapy. The efficacy in the CS group, defined as undergoing complete resection after chemotherapy, was analyzed, and compared with the non-CS group; then, contributing factors to achieving CS were extracted. We also analyzed differences in the efficacy of CS between locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer (MPC). Results: Overall, CS was achieved in 4.3% of cases, eight patients (13.3%) with LAPC and five (2.1%) with MPC. Contributing factors to CS were LAPC, no liver metastasis, CA19-9 ≤37, and chemotherapy response. After adjusting for these, overall survival was significantly better in the CS group than in the non-CS group [median of 32.9 vs. 11.3 months; adjusted hazard ratio (HR)=0.32; 95% confidence interval (CI)=0.14-0.70; p<0.01]. Median relapse-free survival duration after CS was 19.1 and 18.1 months in the LAPC-CS and MPC-CS group, respectively (p=0.84). The median post-conversion survival was 27.6 months in the entire CS group, 43.8 months in the LAPC-CS group and 21.3 months in the MPC-CS group. Conclusion: CS was achieved in 13.3% of LAPC and 2.1% of MPC cases. If possible, CS can markedly improve prognosis, even in MPC.