Detailed Abstract
[Poster Presentation 8 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 8-S3] Upfront Surgery Versus Neoadjuvant Chemotherapy with FOLFIRINOX for Resectable Pancreatic Ductal Adenocarcinoma
Zhongkai WANG 2, Su Hyeong PARK 1, Chang Moo KANG 1
1 Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Korea, REPUBLIC OF KOREA, 2 Division of Hepatobiliary And Pancreatic Surgery, Department of Surgery, Woodlands Health, Singapore & Singapore General Hospital, Singapore, SINGAPORE
Background : Neoadjuvant chemotherapy has become standard of care for borderline resectable and locally advanced disease, particularly with FOLFIRINOX. However, the use of FOLFIRINOX neoadjuvant therapy for radiologically upfront resectable disease remains in question.
Methods : Between January 2020 to August 2022, a total of 199 consecutive patients with resectable pancreatic cancer underwent surgery at Severance Hospital, Korea. The data was collected prospectively. The total duration of follow up in this study is 1 year. Statistical matching and analysis using Inverse Probability of Treatment Weighting (IPTW) was performed.
Results : 199 patients underwent surgery for PDAC during the study period. 82 patients received neoadjuvant chemotherapy with FOLFIRINOX while 117 did not receive any neoadjuvant treatment. There were no significant differences in intra-operative markers, complication rates, 30- and 90-days mortality. The Disease-Free Survival (DFS) and Overall Survival (OS) comparison between the 2 main groups also did not show any significant differences. On regression analysis, the following factors impacted DFS and OS overall; ASA score, presence of pre-operative cholangitis, positive nodal disease, lymphovascular invasion, perineural invasion, post-operative pancreatic-fistula and bile leak. Minimal invasive surgery for both groups yielded benefits in intra-operative blood loss (Group A: 150ml vs 200ml, p=0.009; Group B 100ml vs 300ml, p <0.001) sand hospital length of stay (Group A: 10 vs 13 days, p=0.003; Group B 9 vs 16 days, p<0.001).
Conclusions : Neoadjuvant chemotherapy with FOLFIRINOX offers no benefits in DFS and OS at 1 year follow-up. Minimal invasive surgery is associated with a lower intra-operative blood loss and shorter hospital stay in our experience.
Methods : Between January 2020 to August 2022, a total of 199 consecutive patients with resectable pancreatic cancer underwent surgery at Severance Hospital, Korea. The data was collected prospectively. The total duration of follow up in this study is 1 year. Statistical matching and analysis using Inverse Probability of Treatment Weighting (IPTW) was performed.
Results : 199 patients underwent surgery for PDAC during the study period. 82 patients received neoadjuvant chemotherapy with FOLFIRINOX while 117 did not receive any neoadjuvant treatment. There were no significant differences in intra-operative markers, complication rates, 30- and 90-days mortality. The Disease-Free Survival (DFS) and Overall Survival (OS) comparison between the 2 main groups also did not show any significant differences. On regression analysis, the following factors impacted DFS and OS overall; ASA score, presence of pre-operative cholangitis, positive nodal disease, lymphovascular invasion, perineural invasion, post-operative pancreatic-fistula and bile leak. Minimal invasive surgery for both groups yielded benefits in intra-operative blood loss (Group A: 150ml vs 200ml, p=0.009; Group B 100ml vs 300ml, p <0.001) sand hospital length of stay (Group A: 10 vs 13 days, p=0.003; Group B 9 vs 16 days, p<0.001).
Conclusions : Neoadjuvant chemotherapy with FOLFIRINOX offers no benefits in DFS and OS at 1 year follow-up. Minimal invasive surgery is associated with a lower intra-operative blood loss and shorter hospital stay in our experience.
SESSION
Poster Presentation 8
Zone B 3/22/2024 2:50 PM - 3:40 PM