TY - JOUR T1 - Conversion Surgery for Unresectable Pancreatic Cancer Treated With FOLFIRINOX or Gemcitabine Plus Nab-paclitaxel JF - Anticancer Research JO - Anticancer Res SP - 1817 LP - 1826 DO - 10.21873/anticanres.16335 VL - 43 IS - 4 AU - YASUSHI IDE AU - TAIGA OTSUKA AU - MOTOTSUGU SHIMOKAWA AU - FUTA KOGA AU - YUJIRO UEDA AU - JUNICHI NAKAZAWA AU - AZUSA KOMORI AU - SATOSHI OTSU AU - SHIHO ARIMA AU - MASARU FUKAHORI AU - AKITAKA MAKIYAMA AU - YUDAI SHINOHARA AU - SHOHEI UENO AU - HIROKI TAGUCHI AU - TAKUYA HONDA AU - TARO SHIBUKI AU - KENTA NIO AU - NORIO URESHINO AU - TOSHIHIKO MIZUTA AU - KENJI MITSUGI AU - TSUYOSHI SHIRAKAWA Y1 - 2023/04/01 UR - http://ar.iiarjournals.org/content/43/4/1817.abstract N2 - 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. ER -