Evidence map›Paper›PMID 33229503›Full record

ArticleESMO open2020

Neoadjuvant treatment for locally advanced unresectable and borderline resectable pancreatic cancer: oncological outcomes at a single academic centre.

Susana Roselló, Claudio Pizzo, Marisol Huerta, Elena Muñoz, Roberto Aliaga, Almudena Vera, Clara Alfaro-Cervelló, Esther Jordá, Marina Garcés-Albir, Desamparados Roda and 12 more

Open access · goldAbstract read
In one paragraph

Article in ESMO open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
0.3field-weighted citation impact, top 41% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 12 citations in OpenAlex.

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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

22 authors at 4 institutions in 2 countries.

Susana RosellóMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
Claudio PizzoOncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Cremona, Italy.
Marisol HuertaMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Elena MuñozSurgery, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Roberto AliagaRadiology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Almudena VeraRadiology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Clara Alfaro-CervellóPathology, Biomedical Research Institute Incliva, Hospital Clínico Universitario, Valencia, Spain.
Esther JordáRadiation Oncology, Biomedical Research Institute Incliva, Hospital Clínico Universitario, Valencia, Spain.
Marina Garcés-AlbirSurgery, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Desamparados RodaMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
Dimitri DorcarattoSurgery, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Noelia TarazonaMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
Sergio TorondelRadiology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Jorge GuijarroRadiology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Vicente SánchizGastroenterology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Valentina GambardellaMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
Tania Fleitas-KanonnikoffMedical Oncology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
Paloma LluchGastroenterology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain.
Isabel PascualGastroenterology, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; Gastroenterology, University of Valencia, Valencia, Spain.
Antonio FerrándezPathology, Biomedical Research Institute Incliva, Hospital Clínico Universitario, Valencia, Spain; Pathology, University of Valencia, Valencia, Spain.
Luis SabaterSurgery, Biomedical Research Institute INCLIVA. Hospital Clínico Universitario, Valencia, Spain; Surgery, University of Valencia, Valencia, Spain.
Andrés CervantesCIBERONC, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain; Department of Medical Oncology, University of Valencia, Valencia, Spain. Electronic address: andres.cervantes@uv.es.
INCLIVA Health Research Institute · ESInstituto de Salud Carlos III · ESUniversitat de València · ESIstituti Ospitalieri di Cremona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPancreatic cancer (PC), even in the absence of metastatic disease, has a dismal prognosis. One-third of them are borderline resectable (BRPC) or locally advanced unresectable PC (LAUPC) at diagnosis. There are limited prospective data supporting the best approach on these tumours. Neoadjuvant chemotherapy (ChT) is being increasingly used in this setting.

methodsThis is a retrospective series of consecutive patients staged as BRPC or LAUPC after discussion in the multidisciplinary board (MDB) at an academic centre. All received neoadjuvant ChT, followed by chemoradiation (ChRT) in some cases, and those achieving enough downstaging had a curative-intent surgery. Descriptive data about patient's characteristics, neoadjuvant treatments, toxicities, curative resections, postoperative complications, pathology reports and adjuvant treatment were collected. Overall survival (OS) and progression-free survival was calculated with Kaplan-Meier method and log-rank test.

resultsBetween August 2011 and July 2019, 49 patients fulfilled the inclusion criteria, and all of them received neoadjuvant ChT. Fluorouracil+folinic acid, irinotecan and oxaliplatin was the most frequently used scheme (77%). The most prevalent grade 3 or 4 toxicities were neutropenia (26.5%), neurotoxicity (12.2%), diarrhoea (8.2%) and nausea (8.2%). 18 patients (36.7%) received ChRT thereafter. In total, 22 patients (44,9%) became potentially resectable and 19 of them had an R0 or R1 pancreatic resection. One was found to be unresectable at surgery and two refused surgery. A vascular resection was required in 7 (35%). No postoperative deaths were observed. Postoperative ChT was given to 12 (66.7%) of resected patients. Median OS of the whole cohort was 24,9 months (95% CI 14.1 to 35.7), with 30.6 months for resected and 13.1 months for non-resected patients, respectively (p<0.001).

conclusionA neoadjuvant approach in BRPC and LAUPC was well tolerated and allowed a curative resection in 38.8% of them with a potential improvement on OS.

Indexed as

AdenocarcinomaPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsHumansNeoadjuvant TherapyProspective StudiesRetrospective Studiesborderline resectableFOLFIRINOXlocally advanced unresectableneoadjuvant therapypancreatic cancer

Identifiers

PMID33229503
PMCPMC7684818
OpenAlexW3107960293

What OpenQuestion holds

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Registered trials

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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.