Patient outcome according to the 2017 international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma
We evaluated the usefulness of the 2017 definition of borderline pancreatic ductal adenocarcinoma (BR-PDAC) in fit patients (performance status 0–1) based on anatomical (A) and biological dimensions (B). From 2011 to 2018, 139 resected patients with BR-PDAC according to the 2017 definition were incl...
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| Veröffentlicht in: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2020-03, Vol.20 (2), p.223-228 |
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| container_title | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] |
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| creator | Medrano, J. Garnier, J. Ewald, J. Marchese, U. Gilabert, M. Launay, S. Poizat, F. Giovannini, M. Delpero, J.R. Turrini, O. |
| description | We evaluated the usefulness of the 2017 definition of borderline pancreatic ductal adenocarcinoma (BR-PDAC) in fit patients (performance status 0–1) based on anatomical (A) and biological dimensions (B).
From 2011 to 2018, 139 resected patients with BR-PDAC according to the 2017 definition were included: 18 patients underwent upfront pancreatectomy (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; BR-B group), and 121 received FOLFIRINOX (FX) induction chemotherapy and were divided into BR-A (CA 19-9 500 U/mL and/or regional lymph node metastasis; n = 53) groups.
The 3 groups were comparable according to patient characteristics (except for back pain (P |
| doi_str_mv | 10.1016/j.pan.2019.12.001 |
| format | Article |
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From 2011 to 2018, 139 resected patients with BR-PDAC according to the 2017 definition were included: 18 patients underwent upfront pancreatectomy (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; BR-B group), and 121 received FOLFIRINOX (FX) induction chemotherapy and were divided into BR-A (CA 19-9 < 500 U/mL, no regional lymph node metastasis; n = 68) and BR-AB (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; n = 53) groups.
The 3 groups were comparable according to patient characteristics (except for back pain (P < .01) and CA 19-9 (P < .01)), intraoperative data, and postoperative courses. BR-AB patients required more venous resections (P < .01). The 3 groups were comparable on pathologic findings, except that BR-B patients had more lymph node invasions (P = .02). Median overall survival (OS) of the 121 patients was 45 months. In multivariate analysis, venous resection (P = .039) and R1 resection (P = .012) were poorly linked with OS, whereas BR-A classification (P < .01) independently favored OS. Median survival times of BR-A, BR-AB, and BR-B groups were undetermined, 27 months, and 20 months (P < .001), respectively.
The 2017 definition was relevant for sub-classifying patients with BR-PDAC. The anatomical dimension (BR-A) was a favorable prognostic factor, whereas the biological dimension (BR-AB and BR-B) poorly impacted survival.]]></description><identifier>ISSN: 1424-3903</identifier><identifier>EISSN: 1424-3911</identifier><identifier>DOI: 10.1016/j.pan.2019.12.001</identifier><identifier>PMID: 31839458</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Adenocarcinoma ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Borderline ; Carcinoma, Pancreatic Ductal - drug therapy ; Carcinoma, Pancreatic Ductal - surgery ; Chemotherapy ; Classification ; Consensus ; Female ; Fluorouracil - therapeutic use ; Folfirinox ; Humans ; Irinotecan - therapeutic use ; Leucovorin - therapeutic use ; Lymph nodes ; Lymphatic Metastasis ; Lymphatic system ; Male ; Metastases ; Metastasis ; Middle Aged ; Mortality ; Multivariate analysis ; Neoplasm Staging ; Oxaliplatin - therapeutic use ; Pancreas ; Pancreatectomy ; Pancreatic adenocarcinoma ; Pancreatic cancer ; Pancreatic Neoplasms - drug therapy ; Pancreatic Neoplasms - surgery ; Patients ; Reference Standards ; Surgery ; Survival ; Survival Analysis ; Treatment Outcome ; Veins & arteries</subject><ispartof>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2020-03, Vol.20 (2), p.223-228</ispartof><rights>2019 IAP and EPC</rights><rights>Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.</rights><rights>2019. IAP and EPC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-7e9370efe04a7292dbe930492ea12dacd0696823cbc51c2cc68f76e24ad6e3a83</citedby><cites>FETCH-LOGICAL-c490t-7e9370efe04a7292dbe930492ea12dacd0696823cbc51c2cc68f76e24ad6e3a83</cites><orcidid>0000-0002-2144-2380 ; 0000-0001-5481-2926</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31839458$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Medrano, J.</creatorcontrib><creatorcontrib>Garnier, J.</creatorcontrib><creatorcontrib>Ewald, J.</creatorcontrib><creatorcontrib>Marchese, U.</creatorcontrib><creatorcontrib>Gilabert, M.</creatorcontrib><creatorcontrib>Launay, S.</creatorcontrib><creatorcontrib>Poizat, F.</creatorcontrib><creatorcontrib>Giovannini, M.</creatorcontrib><creatorcontrib>Delpero, J.R.</creatorcontrib><creatorcontrib>Turrini, O.</creatorcontrib><title>Patient outcome according to the 2017 international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma</title><title>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</title><addtitle>Pancreatology</addtitle><description><![CDATA[We evaluated the usefulness of the 2017 definition of borderline pancreatic ductal adenocarcinoma (BR-PDAC) in fit patients (performance status 0–1) based on anatomical (A) and biological dimensions (B).
From 2011 to 2018, 139 resected patients with BR-PDAC according to the 2017 definition were included: 18 patients underwent upfront pancreatectomy (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; BR-B group), and 121 received FOLFIRINOX (FX) induction chemotherapy and were divided into BR-A (CA 19-9 < 500 U/mL, no regional lymph node metastasis; n = 68) and BR-AB (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; n = 53) groups.
The 3 groups were comparable according to patient characteristics (except for back pain (P < .01) and CA 19-9 (P < .01)), intraoperative data, and postoperative courses. BR-AB patients required more venous resections (P < .01). The 3 groups were comparable on pathologic findings, except that BR-B patients had more lymph node invasions (P = .02). Median overall survival (OS) of the 121 patients was 45 months. In multivariate analysis, venous resection (P = .039) and R1 resection (P = .012) were poorly linked with OS, whereas BR-A classification (P < .01) independently favored OS. Median survival times of BR-A, BR-AB, and BR-B groups were undetermined, 27 months, and 20 months (P < .001), respectively.
The 2017 definition was relevant for sub-classifying patients with BR-PDAC. The anatomical dimension (BR-A) was a favorable prognostic factor, whereas the biological dimension (BR-AB and BR-B) poorly impacted survival.]]></description><subject>Adenocarcinoma</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Borderline</subject><subject>Carcinoma, Pancreatic Ductal - drug therapy</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Chemotherapy</subject><subject>Classification</subject><subject>Consensus</subject><subject>Female</subject><subject>Fluorouracil - therapeutic use</subject><subject>Folfirinox</subject><subject>Humans</subject><subject>Irinotecan - therapeutic use</subject><subject>Leucovorin - therapeutic use</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Neoplasm Staging</subject><subject>Oxaliplatin - therapeutic use</subject><subject>Pancreas</subject><subject>Pancreatectomy</subject><subject>Pancreatic adenocarcinoma</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - drug therapy</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Patients</subject><subject>Reference Standards</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Veins & arteries</subject><issn>1424-3903</issn><issn>1424-3911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vFSEUhonR2Fr9AW4Mies7coA7M8RV0_jRpIld6JowhzPKzVy4AtOkP8F_Lddbu-wKcnjOE96XsbcgOhDQf9h1Bxc7KcB0IDsh4Bk7By31RhmA5493oc7Yq1J2QkgJYF6yMwWjMno7nrM_t64GipWntWLaE3eIKfsQf_KaeP1FvOkHHmKlHBuaols4plgolrXwFP8xnuYQw_GVp5lPTUB5CZF4pkJY3bQQb1_FTE2B3K9ttnDnKSZ0GUNMe_eavZjdUujNw3nBfnz-9P3q6-bm25frq8ubDWoj6mYgowZBMwntBmmkn9pAaCPJgfQOvehNP0qFE24BJWI_zkNPUjvfk3KjumDvT95DTr9XKtXu0tqyLcVKDYPYKtBHCk4U5lRKptkecti7fG9B2GP5dmdbInss34K0rfy28-7BvE578o8b_9tuwMcTQC3fXaBsC7bykXzIrSbrU3hC_xezJpdV</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Medrano, J.</creator><creator>Garnier, J.</creator><creator>Ewald, J.</creator><creator>Marchese, U.</creator><creator>Gilabert, M.</creator><creator>Launay, S.</creator><creator>Poizat, F.</creator><creator>Giovannini, M.</creator><creator>Delpero, J.R.</creator><creator>Turrini, O.</creator><general>Elsevier B.V</general><general>Elsevier Limited</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>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0002-2144-2380</orcidid><orcidid>https://orcid.org/0000-0001-5481-2926</orcidid></search><sort><creationdate>202003</creationdate><title>Patient outcome according to the 2017 international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma</title><author>Medrano, J. ; Garnier, J. ; Ewald, J. ; Marchese, U. ; Gilabert, M. ; Launay, S. ; Poizat, F. ; Giovannini, M. ; Delpero, J.R. ; Turrini, O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-7e9370efe04a7292dbe930492ea12dacd0696823cbc51c2cc68f76e24ad6e3a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Borderline</topic><topic>Carcinoma, Pancreatic Ductal - drug therapy</topic><topic>Carcinoma, Pancreatic Ductal - surgery</topic><topic>Chemotherapy</topic><topic>Classification</topic><topic>Consensus</topic><topic>Female</topic><topic>Fluorouracil - therapeutic use</topic><topic>Folfirinox</topic><topic>Humans</topic><topic>Irinotecan - therapeutic use</topic><topic>Leucovorin - therapeutic use</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Neoplasm Staging</topic><topic>Oxaliplatin - therapeutic use</topic><topic>Pancreas</topic><topic>Pancreatectomy</topic><topic>Pancreatic adenocarcinoma</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - drug therapy</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Patients</topic><topic>Reference Standards</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Medrano, J.</creatorcontrib><creatorcontrib>Garnier, J.</creatorcontrib><creatorcontrib>Ewald, J.</creatorcontrib><creatorcontrib>Marchese, U.</creatorcontrib><creatorcontrib>Gilabert, M.</creatorcontrib><creatorcontrib>Launay, S.</creatorcontrib><creatorcontrib>Poizat, F.</creatorcontrib><creatorcontrib>Giovannini, M.</creatorcontrib><creatorcontrib>Delpero, J.R.</creatorcontrib><creatorcontrib>Turrini, O.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Medrano, J.</au><au>Garnier, J.</au><au>Ewald, J.</au><au>Marchese, U.</au><au>Gilabert, M.</au><au>Launay, S.</au><au>Poizat, F.</au><au>Giovannini, M.</au><au>Delpero, J.R.</au><au>Turrini, O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient outcome according to the 2017 international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma</atitle><jtitle>Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]</jtitle><addtitle>Pancreatology</addtitle><date>2020-03</date><risdate>2020</risdate><volume>20</volume><issue>2</issue><spage>223</spage><epage>228</epage><pages>223-228</pages><issn>1424-3903</issn><eissn>1424-3911</eissn><abstract><![CDATA[We evaluated the usefulness of the 2017 definition of borderline pancreatic ductal adenocarcinoma (BR-PDAC) in fit patients (performance status 0–1) based on anatomical (A) and biological dimensions (B).
From 2011 to 2018, 139 resected patients with BR-PDAC according to the 2017 definition were included: 18 patients underwent upfront pancreatectomy (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; BR-B group), and 121 received FOLFIRINOX (FX) induction chemotherapy and were divided into BR-A (CA 19-9 < 500 U/mL, no regional lymph node metastasis; n = 68) and BR-AB (CA 19-9 > 500 U/mL and/or regional lymph node metastasis; n = 53) groups.
The 3 groups were comparable according to patient characteristics (except for back pain (P < .01) and CA 19-9 (P < .01)), intraoperative data, and postoperative courses. BR-AB patients required more venous resections (P < .01). The 3 groups were comparable on pathologic findings, except that BR-B patients had more lymph node invasions (P = .02). Median overall survival (OS) of the 121 patients was 45 months. In multivariate analysis, venous resection (P = .039) and R1 resection (P = .012) were poorly linked with OS, whereas BR-A classification (P < .01) independently favored OS. Median survival times of BR-A, BR-AB, and BR-B groups were undetermined, 27 months, and 20 months (P < .001), respectively.
The 2017 definition was relevant for sub-classifying patients with BR-PDAC. The anatomical dimension (BR-A) was a favorable prognostic factor, whereas the biological dimension (BR-AB and BR-B) poorly impacted survival.]]></abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>31839458</pmid><doi>10.1016/j.pan.2019.12.001</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-2144-2380</orcidid><orcidid>https://orcid.org/0000-0001-5481-2926</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Borderline Carcinoma, Pancreatic Ductal - drug therapy Carcinoma, Pancreatic Ductal - surgery Chemotherapy Classification Consensus Female Fluorouracil - therapeutic use Folfirinox Humans Irinotecan - therapeutic use Leucovorin - therapeutic use Lymph nodes Lymphatic Metastasis Lymphatic system Male Metastases Metastasis Middle Aged Mortality Multivariate analysis Neoplasm Staging Oxaliplatin - therapeutic use Pancreas Pancreatectomy Pancreatic adenocarcinoma Pancreatic cancer Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - surgery Patients Reference Standards Surgery Survival Survival Analysis Treatment Outcome Veins & arteries |
| title | Patient outcome according to the 2017 international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma |
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