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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1510016
This article is part of the Research Topic Novel Approaches in the Management of Hepatobiliary Pancreatic Cancer View all articles

Survival benefits of adjuvant chemotherapy after conversion surgery in patients with advanced pancreatic cancer

Provisionally accepted
Yoon Suk Lee Yoon Suk Lee 1Jang Won Lee Jang Won Lee 2Hak-June Kim Hak-June Kim 2Jung Won Chun Jung Won Chun 3Jong-Chan Lee Jong-Chan Lee 4Dong Kee Jang Dong Kee Jang 5Jin-Hyeok Hwang Jin-Hyeok Hwang 4Young Ae Kim Young Ae Kim 6SANG MYUNG WOO SANG MYUNG WOO 3*
  • 1 Inje University Ilsan Paik Hospital, Goyang-si, Republic of Korea
  • 2 Cancer Management Policy Department, National Cancer Center (South Korea), Goyang, Gyeonggi, Republic of Korea
  • 3 Research Institute, Center for Liver and Pancreatobiliary Cancer, National Cancer Center,, Goyang, Republic of Korea
  • 4 Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi, Republic of Korea
  • 5 Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea
  • 6 Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center,, Goyang, Republic of Korea

The final, formatted version of the article will be published soon.

    Background: Oncologic outcomes of conversion surgery for advanced pancreatic cancer (PC) have scarcely been reported. Therefore, this study aimed to investigate the outcomes of conversion surgery with preoperative treatment of FOLFIRINOX or gemcitabine with nabpaclitaxel (GnP) for patients with advanced PC including locally advanced or metastatic PC.: Using the National Health Insurance database between 2005 and 2020, we identified patients who underwent conversion surgery after chemotherapy with FOLFIRINOX or GnP for advanced PC. The patients were categorized based on preoperative treatment. Survival outcomes were evaluated based on the date of cancer diagnosis and conversion surgery.Results: Among 69,183 patients with advanced PC, 476 underwent conversion surgery; 430 with FOLFIRINOX and 46 with GnP. The median duration from diagnosis to conversion surgery was 6.4 months. Overall survival (OS) was 31.2 months after cancer diagnosis and 23.5 months after conversion surgery. Adjuvant chemotherapy was a significant factor for OS, with hazard ratios (HRs) of 0.23 [95% CI 0.12-0.44, P < 0.01] from cancer diagnosis and 0.20 [95% CI 0.10-0.37, P < 0.01] from conversion surgery. No significant differences were noted between FOLFIRINOX and GnP. However, maintaining the same regimens as preoperative chemotherapy was a significant factor, with HRs of 0.67 [95% CI 0.47-0.95, P = 0.02] from cancer diagnosis and 0.69 [95% CI 0.49-0.98, P = 0.04] from conversion surgery.The incorporation of adjuvant chemotherapy with the same preoperative regimen could be an effective strategy for patients with advanced PC who would undergo conversion surgery.

    Keywords: Surgical Procedures, Operative, FOLFIRINOX, Albumin-Bounded Paclitaxel, Carcinoma, Pancreatic Ductal, survival analysis

    Received: 12 Oct 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Suk Lee, Lee, Kim, Chun, Lee, Jang, Hwang, Kim and WOO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: SANG MYUNG WOO, Research Institute, Center for Liver and Pancreatobiliary Cancer, National Cancer Center,, Goyang, Republic of Korea

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