Evidence map›Paper›PMID 29679211›Full record

ArticleEuropean radiology2018

Surgery after FOLFIRINOX treatment for locally advanced and borderline resectable pancreatic cancer: increase in tumour attenuation on CT correlates with R0 resection.

Giovanni Marchegiani, Valentina Todaro, Enrico Boninsegna, Riccardo Negrelli, Binit Sureka, Debora Bonamini, Roberto Salvia, Riccardo Manfredi, Roberto Pozzi Mucelli, Claudio Bassi

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05298722 (Prediction of Surgical Resectability After FOLFIRINOX Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05298722 narecruitingnot on this mapstarted 2022, after this paper: background citation

Prediction of Surgical Resectability After FOLFIRINOX Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: the Role of Diffusion Weighted Magnetic Resonance Imaging, Radiomics and Liquid Biopsy

TypeinterventionalSponsorUniversity Hospital, GhentRan2022 to 2028Enrolled45ConditionsPancreatic CancerArmsImaging analysis of CT-scan and MRI with radiomics and genetic analysis of peripheral blood samples and questionnaires.
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Locally Advanced Pancreas Cancer, Is There a Role for Surgery?The Surgical clinics of North America · 2024
    Review
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  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. [Surgical treatment of pancreatic cancer-What is new?]Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022
    Review
  13. Article
  14. Article
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Giovanni MarchegianiDepartment of General Surgery, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Valentina TodaroDepartment of General Surgery, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Enrico BoninsegnaDepartment of Radiology, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Riccardo NegrelliDepartment of Radiology, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Binit SurekaInstitute of Liver and Biliary Sciences of New Delhi, New Delhi, India.
Debora BonaminiDepartment of General Surgery, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Roberto SalviaDepartment of General Surgery, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Riccardo ManfrediDepartment of Radiology of the Policlinico Gemelli, Catholic University of Rome, Rome, Italy.
Roberto Pozzi MucelliDepartment of Radiology, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy.
Claudio BassiDepartment of General Surgery, Verona University Hospital, Policlinico G. B. Rossi, P.le Scuro 10, 37134, Verona, Italy. claudio.bassi@univr.it.
University of Verona · ITAgostino Gemelli University Polyclinic · ITInstitute of Liver and Biliary Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX.

methodsPatients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared.

resultsOf 59 patients included, 19 were defined as unresectable (32%), 33 borderline resectable (56%) and 7 resectable (12%) during the blind radiological evaluation after FOLFIRINOX. Once in a surgical setting, 27% were non-resectable, whereas 73% received surgical resection with a 70% R0 rate. Consequent sensitivity and specificity were 86% and 29%. At imaging review, significant decreases in longest tumour dimension were observed in both groups: from 32 mm (95% CI 15-55) to 21 (10-44) in group A and from 34 (18-70) to 26 (7-60) in group B, p < 0.05. However, a significant increase in tumour attenuation in all phases was only observed for R0 resected, from 52 HU (26-75) to 65 (35-92) in arterial phase (p < 0.001) and from 62 (36-96) to 78 (40-120) in the venous (p = 0.001).

conclusionAfter neoadjuvant FOLFIRINOX, CT predicted resectability with acceptable sensitivity but low specificity. The observation of increased tumour attenuation at CT scan after FOLFIRINOX treatment might represent a reliable predictor of R0 resection. KEY POINTS: • CT drives the assessment of PDAC resectability after FOLFIRINOX • CT predicts resectability with acceptable sensitivity but low specificity • Significant increase in tumour attenuation was only observed for R0 resected PDAC • Tumour attenuation after FOLFIRINOX represents a reliable predictor of R0 resection.

Indexed as

AdultAgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalDrug CombinationsFemaleFluorouracilHumansIrinotecanLeucovorinMaleMiddle AgedNeoadjuvant TherapyNeoplasm StagingOrganometallic CompoundsOxaliplatinDrug CombinationsFluorouracilfolfirinoxIrinotecanLeucovorinOrganometallic CompoundsOxaliplatinInduction chemotherapyMultidetector computed tomographyNeoplasm stagingPancreas ductal carcinomaPancreatectomy

Identifiers

PMID29679211
OpenAlexW2799649329

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.