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- W3209850523 abstract "Purpose: Patients with metastatic pancreatic cancer (mPDAC) are usually no candidates for surgical resection. However, the role of conversion surgery for mPDAC patients with exceptional response to chemotherapy is unclear. Method: Patients undergoing surgical exploration following chemotherapy for mPDAC between 2011 to 2018 were identified from a prospectively maintained database. Data on demographics, treatment, pathology, and outcomes were collected. Uni- and multivariate survival analyses were performed. Results: 320 patients underwent surgery after chemotherapy with Gemcitabine (46.9%), FOLFIRINOX (43.8%) or combination regimens (9.3%). After a median duration of chemotherapy of 6.1 months, 110 patients (34.4%) underwent resection of the primary tumor and metastatic sites and 210 patients (65.6%) underwent exploration only. Of the resected subgroup, 45 patients (40.1%) had complete pathological response of metastases (ypM0) and 65 patients (59.9%) had residual metastases (ypM1). ypM0 was significantly associated with lower preoperative CA19-9, longer duration of chemotherapy and administration of FOLFIRINOX. Median survival after resection was 25.5 months in ypM0, 11.3 months in ypM1 and 8.0 months in patients without resection (2-year survival rates were 58.7%, 24.7% and 3.9%, respectively) (p<0.001). Additional adjuvant chemotherapy was associated with improved survival after resection (21.8 vs 11.4 months, p=0.027). Conclusion: In patients with mPDAC and exceptional response to chemotherapy surgical resection is associated with encouraging survival in ypM0 but not in ypM1 patients. Surgical exploration may, therefore, be recommended in mPDAC patients with good response to chemotherapy and resection may be recommended in ypM0 status. Addition of adjuvant chemotherapy appears to confer an additional survival advantage." @default.
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- W3209850523 date "2021-01-01" @default.
- W3209850523 modified "2023-09-26" @default.
- W3209850523 title "Outcome of Conversion Surgery after Chemotherapy for Metastatic Pancreatic Cancer" @default.
- W3209850523 doi "https://doi.org/10.1016/j.hpb.2021.08.104" @default.
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