Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC)
This document is a summary of the French intergroup guidelines regarding the management of pancreatic adenocarcinoma (PA), updated in July 2018. This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the p...
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Veröffentlicht in: | Digestive and liver disease 2018-12, Vol.50 (12), p.1257-1271 |
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creator | Neuzillet, Cindy Gaujoux, Sébastien Williet, Nicolas Bachet, Jean-Baptiste Bauguion, Lucile Colson Durand, Laurianne Conroy, Thierry Dahan, Laetitia Gilabert, Marine Huguet, Florence Marthey, Lysiane Meilleroux, Julie de Mestier, Louis Napoléon, Bertrand Portales, Fabienne Sa Cunha, Antonio Schwarz, Lilian Taieb, Julien Chibaudel, Benoist Bouché, Olivier Hammel, Pascal |
description | This document is a summary of the French intergroup guidelines regarding the management of pancreatic adenocarcinoma (PA), updated in July 2018.
This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the previous guidelines, recent literature review and expert opinions. Recommendations were graded in three categories, according to the level of evidence.
Over the last seven years, significant changes in PA management have been implemented in clinical practice. Imaging/staging: diffusion magnetic resonance imaging is useful before surgery to rule out small liver metastases. Surgery: centralization of pancreatic surgery in expert centers is associated with a decreased postoperative mortality. Adjuvant chemotherapy: modified FOLFIRINOX in fit patients, or gemcitabine, or 5-FU, or gemcitabine plus capecitabine, to be discussed on a case-by-case basis. Locally advanced PA: no survival benefit of chemoradiotherapy. Metastatic PA: FOLFIRINOX and gemcitabine plus nab-paclitaxel combination are first-line standards in fit patients; second-line with 5FU/nal-IRI or 5FU/oxaliplatin combination after first-line gemcitabine.
Guidelines for management of PA are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research. However, as each individual case is particular, they cannot substitute to multidisciplinary tumor board discussion. |
doi_str_mv | 10.1016/j.dld.2018.08.008 |
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This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the previous guidelines, recent literature review and expert opinions. Recommendations were graded in three categories, according to the level of evidence.
Over the last seven years, significant changes in PA management have been implemented in clinical practice. Imaging/staging: diffusion magnetic resonance imaging is useful before surgery to rule out small liver metastases. Surgery: centralization of pancreatic surgery in expert centers is associated with a decreased postoperative mortality. Adjuvant chemotherapy: modified FOLFIRINOX in fit patients, or gemcitabine, or 5-FU, or gemcitabine plus capecitabine, to be discussed on a case-by-case basis. Locally advanced PA: no survival benefit of chemoradiotherapy. Metastatic PA: FOLFIRINOX and gemcitabine plus nab-paclitaxel combination are first-line standards in fit patients; second-line with 5FU/nal-IRI or 5FU/oxaliplatin combination after first-line gemcitabine.
Guidelines for management of PA are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research. However, as each individual case is particular, they cannot substitute to multidisciplinary tumor board discussion.</description><identifier>ISSN: 1590-8658</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2018.08.008</identifier><identifier>PMID: 30219670</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy ; France ; French intergroup clinical practice guidelines ; Humans ; Life Sciences ; Pancreatic adenocarcinoma ; Pancreatic Neoplasms ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - therapy ; Practice Guidelines as Topic ; Prognosis ; Radiotherapy ; Societies, Medical ; Surgery ; Surgical Procedures, Operative</subject><ispartof>Digestive and liver disease, 2018-12, Vol.50 (12), p.1257-1271</ispartof><rights>2018 Editrice Gastroenterologica Italiana S.r.l.</rights><rights>Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-cb68f2fe5f6d7da44f321832b12d76ae5db166b75baab91a02e14b2495f89d323</citedby><cites>FETCH-LOGICAL-c387t-cb68f2fe5f6d7da44f321832b12d76ae5db166b75baab91a02e14b2495f89d323</cites><orcidid>0000-0001-9715-9189 ; 0000-0001-7037-7477 ; 0000-0001-7548-284X ; 0000-0002-9955-4753 ; 0000-0002-7296-5464 ; 0000-0003-4015-5368 ; 0000-0003-1868-3260</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.dld.2018.08.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30219670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://amu.hal.science/hal-02143547$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Neuzillet, Cindy</creatorcontrib><creatorcontrib>Gaujoux, Sébastien</creatorcontrib><creatorcontrib>Williet, Nicolas</creatorcontrib><creatorcontrib>Bachet, Jean-Baptiste</creatorcontrib><creatorcontrib>Bauguion, Lucile</creatorcontrib><creatorcontrib>Colson Durand, Laurianne</creatorcontrib><creatorcontrib>Conroy, Thierry</creatorcontrib><creatorcontrib>Dahan, Laetitia</creatorcontrib><creatorcontrib>Gilabert, Marine</creatorcontrib><creatorcontrib>Huguet, Florence</creatorcontrib><creatorcontrib>Marthey, Lysiane</creatorcontrib><creatorcontrib>Meilleroux, Julie</creatorcontrib><creatorcontrib>de Mestier, Louis</creatorcontrib><creatorcontrib>Napoléon, Bertrand</creatorcontrib><creatorcontrib>Portales, Fabienne</creatorcontrib><creatorcontrib>Sa Cunha, Antonio</creatorcontrib><creatorcontrib>Schwarz, Lilian</creatorcontrib><creatorcontrib>Taieb, Julien</creatorcontrib><creatorcontrib>Chibaudel, Benoist</creatorcontrib><creatorcontrib>Bouché, Olivier</creatorcontrib><creatorcontrib>Hammel, Pascal</creatorcontrib><creatorcontrib>on behalf of the Thésaurus National de Cancérologie Digestive (TNCD)</creatorcontrib><creatorcontrib>Société Française d’Endoscopie Digestive (SFED)</creatorcontrib><creatorcontrib>Fédération Francophone de Cancérologie Digestive (FFCD)</creatorcontrib><creatorcontrib>Groupe Coopérateur multidisciplinaire en Oncologie (GERCOR)</creatorcontrib><creatorcontrib>Association Française de Chirurgie (AFC)</creatorcontrib><creatorcontrib>Société Française de Radiothérapie Oncologique (SFRO)</creatorcontrib><creatorcontrib>Fédération Nationale des Centres de Lutte Contre le Cancer (UNICANCER)</creatorcontrib><creatorcontrib>Société Française de Chirurgie Digestive (SFCD)</creatorcontrib><creatorcontrib>Association de Chirurgie Hépato-Bilio-Pancréatique et Transplantation (ACHBT)</creatorcontrib><creatorcontrib>Société Nationale Française de Gastroentérologie (SNFGE)</creatorcontrib><creatorcontrib>Thésaurus National de Cancérologie Digestive (TNCD)</creatorcontrib><title>Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC)</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>This document is a summary of the French intergroup guidelines regarding the management of pancreatic adenocarcinoma (PA), updated in July 2018.
This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the previous guidelines, recent literature review and expert opinions. Recommendations were graded in three categories, according to the level of evidence.
Over the last seven years, significant changes in PA management have been implemented in clinical practice. Imaging/staging: diffusion magnetic resonance imaging is useful before surgery to rule out small liver metastases. Surgery: centralization of pancreatic surgery in expert centers is associated with a decreased postoperative mortality. Adjuvant chemotherapy: modified FOLFIRINOX in fit patients, or gemcitabine, or 5-FU, or gemcitabine plus capecitabine, to be discussed on a case-by-case basis. Locally advanced PA: no survival benefit of chemoradiotherapy. Metastatic PA: FOLFIRINOX and gemcitabine plus nab-paclitaxel combination are first-line standards in fit patients; second-line with 5FU/nal-IRI or 5FU/oxaliplatin combination after first-line gemcitabine.
Guidelines for management of PA are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research. However, as each individual case is particular, they cannot substitute to multidisciplinary tumor board discussion.</description><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Chemotherapy</subject><subject>France</subject><subject>French intergroup clinical practice guidelines</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Pancreatic adenocarcinoma</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreatic Neoplasms - diagnosis</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Practice Guidelines as Topic</subject><subject>Prognosis</subject><subject>Radiotherapy</subject><subject>Societies, Medical</subject><subject>Surgery</subject><subject>Surgical Procedures, Operative</subject><issn>1590-8658</issn><issn>1878-3562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UUFu2zAQFIoWTZr2Ab0UPCaA5JKUSNHNyVUku4BhF3ZyJihyldCQJZeUUuQvfWzpOM2xwGJ3sDM7h50o-kzwhGDCv-4mpjUTiomY4FBYvInOichFkjJO3wbMpjgRnImz6IP3O4wp4Qy_j87SgKY8x-fRn5-q0w7UYDXSAYL7hioHnX5AurWd1apFB6d04AHdj9ZA2IJHTe-Qseq-6731MRqOFnvoBqQ6E8i27X8n4wFdblfVvIxRVRU3MZqXm2K9idHd6kcxWxVlgNtnYluVz32zjtGsWHy_DaMqrj5G7xrVevj0Mi-iu6q8LRbJcj0PDstEpyIfEl1z0dAGWMNNblSWNSklIqU1oSbnCpipCed1zmql6ilRmALJappNWSOmJqXpRXR18n1QrTw4u1fuSfbKysVsKY-78K4sZVn-SIL28qQ9uP7XCH6Qe-s1tK3qoB-9pAQLygijPEjJSapd772D5tWbYHkMUO5kCFAeA5Q4FBbh5suL_Vjvwbxe_EssCK5PAggPebTgpNc25AXGOtCDNL39j_1fUxelvw</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Neuzillet, Cindy</creator><creator>Gaujoux, Sébastien</creator><creator>Williet, Nicolas</creator><creator>Bachet, Jean-Baptiste</creator><creator>Bauguion, Lucile</creator><creator>Colson Durand, Laurianne</creator><creator>Conroy, Thierry</creator><creator>Dahan, Laetitia</creator><creator>Gilabert, Marine</creator><creator>Huguet, Florence</creator><creator>Marthey, Lysiane</creator><creator>Meilleroux, Julie</creator><creator>de Mestier, Louis</creator><creator>Napoléon, Bertrand</creator><creator>Portales, Fabienne</creator><creator>Sa Cunha, Antonio</creator><creator>Schwarz, Lilian</creator><creator>Taieb, Julien</creator><creator>Chibaudel, Benoist</creator><creator>Bouché, Olivier</creator><creator>Hammel, Pascal</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-9715-9189</orcidid><orcidid>https://orcid.org/0000-0001-7037-7477</orcidid><orcidid>https://orcid.org/0000-0001-7548-284X</orcidid><orcidid>https://orcid.org/0000-0002-9955-4753</orcidid><orcidid>https://orcid.org/0000-0002-7296-5464</orcidid><orcidid>https://orcid.org/0000-0003-4015-5368</orcidid><orcidid>https://orcid.org/0000-0003-1868-3260</orcidid></search><sort><creationdate>20181201</creationdate><title>Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC)</title><author>Neuzillet, Cindy ; Gaujoux, Sébastien ; Williet, Nicolas ; Bachet, Jean-Baptiste ; Bauguion, Lucile ; Colson Durand, Laurianne ; Conroy, Thierry ; Dahan, Laetitia ; Gilabert, Marine ; Huguet, Florence ; Marthey, Lysiane ; Meilleroux, Julie ; de Mestier, Louis ; Napoléon, Bertrand ; Portales, Fabienne ; Sa Cunha, Antonio ; Schwarz, Lilian ; Taieb, Julien ; Chibaudel, Benoist ; Bouché, Olivier ; Hammel, Pascal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-cb68f2fe5f6d7da44f321832b12d76ae5db166b75baab91a02e14b2495f89d323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Chemotherapy</topic><topic>France</topic><topic>French intergroup clinical practice guidelines</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Pancreatic adenocarcinoma</topic><topic>Pancreatic Neoplasms</topic><topic>Pancreatic Neoplasms - 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Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Digestive and liver disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neuzillet, Cindy</au><au>Gaujoux, Sébastien</au><au>Williet, Nicolas</au><au>Bachet, Jean-Baptiste</au><au>Bauguion, Lucile</au><au>Colson Durand, Laurianne</au><au>Conroy, Thierry</au><au>Dahan, Laetitia</au><au>Gilabert, Marine</au><au>Huguet, Florence</au><au>Marthey, Lysiane</au><au>Meilleroux, Julie</au><au>de Mestier, Louis</au><au>Napoléon, Bertrand</au><au>Portales, Fabienne</au><au>Sa Cunha, Antonio</au><au>Schwarz, Lilian</au><au>Taieb, Julien</au><au>Chibaudel, Benoist</au><au>Bouché, Olivier</au><au>Hammel, Pascal</au><aucorp>on behalf of the Thésaurus National de Cancérologie Digestive (TNCD)</aucorp><aucorp>Société Française d’Endoscopie Digestive (SFED)</aucorp><aucorp>Fédération Francophone de Cancérologie Digestive (FFCD)</aucorp><aucorp>Groupe Coopérateur multidisciplinaire en Oncologie (GERCOR)</aucorp><aucorp>Association Française de Chirurgie (AFC)</aucorp><aucorp>Société Française de Radiothérapie Oncologique (SFRO)</aucorp><aucorp>Fédération Nationale des Centres de Lutte Contre le Cancer (UNICANCER)</aucorp><aucorp>Société Française de Chirurgie Digestive (SFCD)</aucorp><aucorp>Association de Chirurgie Hépato-Bilio-Pancréatique et Transplantation (ACHBT)</aucorp><aucorp>Société Nationale Française de Gastroentérologie (SNFGE)</aucorp><aucorp>Thésaurus National de Cancérologie Digestive (TNCD)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC)</atitle><jtitle>Digestive and liver disease</jtitle><addtitle>Dig Liver Dis</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>50</volume><issue>12</issue><spage>1257</spage><epage>1271</epage><pages>1257-1271</pages><issn>1590-8658</issn><eissn>1878-3562</eissn><abstract>This document is a summary of the French intergroup guidelines regarding the management of pancreatic adenocarcinoma (PA), updated in July 2018.
This collaborative work was produced under the auspices of all French medical and surgical societies involved in the management of PA. It is based on the previous guidelines, recent literature review and expert opinions. Recommendations were graded in three categories, according to the level of evidence.
Over the last seven years, significant changes in PA management have been implemented in clinical practice. Imaging/staging: diffusion magnetic resonance imaging is useful before surgery to rule out small liver metastases. Surgery: centralization of pancreatic surgery in expert centers is associated with a decreased postoperative mortality. Adjuvant chemotherapy: modified FOLFIRINOX in fit patients, or gemcitabine, or 5-FU, or gemcitabine plus capecitabine, to be discussed on a case-by-case basis. Locally advanced PA: no survival benefit of chemoradiotherapy. Metastatic PA: FOLFIRINOX and gemcitabine plus nab-paclitaxel combination are first-line standards in fit patients; second-line with 5FU/nal-IRI or 5FU/oxaliplatin combination after first-line gemcitabine.
Guidelines for management of PA are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research. However, as each individual case is particular, they cannot substitute to multidisciplinary tumor board discussion.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>30219670</pmid><doi>10.1016/j.dld.2018.08.008</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-9715-9189</orcidid><orcidid>https://orcid.org/0000-0001-7037-7477</orcidid><orcidid>https://orcid.org/0000-0001-7548-284X</orcidid><orcidid>https://orcid.org/0000-0002-9955-4753</orcidid><orcidid>https://orcid.org/0000-0002-7296-5464</orcidid><orcidid>https://orcid.org/0000-0003-4015-5368</orcidid><orcidid>https://orcid.org/0000-0003-1868-3260</orcidid></addata></record> |
fulltext | fulltext |
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ispartof | Digestive and liver disease, 2018-12, Vol.50 (12), p.1257-1271 |
issn | 1590-8658 1878-3562 |
language | eng |
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source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
subjects | Antineoplastic Combined Chemotherapy Protocols Chemotherapy France French intergroup clinical practice guidelines Humans Life Sciences Pancreatic adenocarcinoma Pancreatic Neoplasms Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - therapy Practice Guidelines as Topic Prognosis Radiotherapy Societies, Medical Surgery Surgical Procedures, Operative |
title | Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC) |
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