Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 190] Clinical Course and Outcomes of Borderline Resectable and Locally Advanced Left-sided Pancreatic cancer Following Neoadjuvant FOLFIRINOX chemotherapy
JANGHUN HAN 1, Ki Byung SONG 1, Woohyung LEE 1, Minkyu SUNG 1, Yejong PARK 1, Bong Jun KWAK 1, Jae Hoon LEE 1, Dae Wook HWANG 1, Song Cheol KIM 1
1 Division of Hepatobiliary And Pancreatic Surgery, Asan Medical Center, REPUBLIC OF KOREA
Background : The utilization of neoadjuvant chemotherapy (NCTx) for pancreatic ductal adenocarcinoma (PDAC) is increasing. However, real-world results of NCTx for PDAC, especially in left-sided PDAC, remain unclear. We conducted a study to investigate the clinical course and outcomes of left-sided PDAC with major vessel involvement following NCTx with modified FOLFIRINOX (m-FOLFIRINOX) therapy.
Methods : We performed a retrospective analysis of 193 patients diagnosed with left-sided PDAC and major vessel involvement who received preoperative m-FOLFIRINOX therapy between January 2017 and December 2020. Clinicopathological data and survival outcomes were compared based on the resectability status at diagnosis and the achievement of curative resection.
Results : Among the 193 patients, 5 (2.6%) had resectable PDAC, 53 (27.5%) had borderline resectable (BR) PDAC, and 135 (69.9%) had locally advanced (LA) PDAC according to the NCCN guidelines. The overall survival (OS) was 46.5 months for the resectable group, 24.2 months for the BR group, and 20.4 months for the LA group (p=0.024). Twenty percent of the patients underwent surgical exploration, and 17.6% (34 out of 193) ultimately underwent surgical resection (resectable, 4/5 [80.0%]; BRPC, 18/53 [34.0%]; LAPC, 12/135 [8.9%]). In the BRPC group, the median survival was 45.2 months for the resected group and 21.9 months for the unresected group (p=0.006). In the LAPC group, the median survival was not reached for the resected group and was 19.1 months for the unresected group (p<0.0001). Among patients who underwent resection, there was no significant difference in clinical and oncologic outcomes between the open and laparoscopic approaches, and there was also no difference in survival outcome based on initial resectability.
Conclusions : This study contributes to a better understanding of the role and potential benefits of NCTx in left-sided PDAC with major vessel involvement. It suggests that for such patients, proceeding to surgical resection may ultimately lead to a favorable prognosis.
Methods : We performed a retrospective analysis of 193 patients diagnosed with left-sided PDAC and major vessel involvement who received preoperative m-FOLFIRINOX therapy between January 2017 and December 2020. Clinicopathological data and survival outcomes were compared based on the resectability status at diagnosis and the achievement of curative resection.
Results : Among the 193 patients, 5 (2.6%) had resectable PDAC, 53 (27.5%) had borderline resectable (BR) PDAC, and 135 (69.9%) had locally advanced (LA) PDAC according to the NCCN guidelines. The overall survival (OS) was 46.5 months for the resectable group, 24.2 months for the BR group, and 20.4 months for the LA group (p=0.024). Twenty percent of the patients underwent surgical exploration, and 17.6% (34 out of 193) ultimately underwent surgical resection (resectable, 4/5 [80.0%]; BRPC, 18/53 [34.0%]; LAPC, 12/135 [8.9%]). In the BRPC group, the median survival was 45.2 months for the resected group and 21.9 months for the unresected group (p=0.006). In the LAPC group, the median survival was not reached for the resected group and was 19.1 months for the unresected group (p<0.0001). Among patients who underwent resection, there was no significant difference in clinical and oncologic outcomes between the open and laparoscopic approaches, and there was also no difference in survival outcome based on initial resectability.
Conclusions : This study contributes to a better understanding of the role and potential benefits of NCTx in left-sided PDAC with major vessel involvement. It suggests that for such patients, proceeding to surgical resection may ultimately lead to a favorable prognosis.
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E-poster
E-Session 03/21 ALL DAY