ArticleAnnals of surgical oncology2022
Anatomic Criteria Determine Resectability in Locally Advanced Pancreatic Cancer.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Surgical outcomes from nationwide implementation of the international best practice for locally advanced pancreatic cancer (PREOPANC-4) study.The British journal of surgery · 2026Observational
- Review
- Anatomical Classification and Staging Systems of Borderline Resectable and Locally Advanced Pancreatic Cancer-A Subgroup Analysis of the NORPACT-2 Trial.Annals of surgical oncology · 2025Article
- The APROVE (Anti-coagulation/Platelet Treatment in Pancreatic Resections Involving Vascular Reconstruction) Study: Results from a Worldwide Survey.Annals of surgical oncology · 2025Article
- Review
- Outcomes in Locally Advanced Pancreatic Cancer After Induction Ablative Radiation Therapy and Resection.Annals of surgical oncology · 2025Article
- Nationwide implementation of the international multidisciplinary best-practice for locally advanced pancreatic cancer (PREOPANC-4): study protocol.BMC cancer · 2025Article
- Carbohydrate antigen 19-9 (CA19-9) response after induction FOLFIRINOX for locally advanced pancreatic cancer identifies patients who may benefit from surgical exploration: multicentre, observational cohort study.The British journal of surgery · 2025Observational
- Long-Term Patency Rates of Portal Vein/Superior Mesenteric Vein Reconstruction after Pancreatic Resection for Pancreatic Tumors: Single-Center Experience.Life (Basel, Switzerland) · 2024Article
- Reappraisal of the current resectability criteria and optimal treatment strategies for pancreatic cancer.Journal of gastrointestinal oncology · 2024Article
- Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2024Review
- Article
- Assessment of the level III of Inoue by preoperative endoscopic ultrasound and elastography: a novel approach to predict a periarterial divestment technique in borderline resectable (BR) or locally advanced (LA) pancreatic adenocarcinoma-How I do it.Langenbeck's archives of surgery · 2023Article
- The Role of Diffusion-Weighted Magnetic Resonance Imaging in Staging after Neoadjuvant Chemotherapy in Locally Advanced Pancreatic Adenocarcinoma.Annals of surgical oncology · 2022Article
- Delta radiomics analysis of Magnetic Resonance guided radiotherapy imaging data can enable treatment response prediction in pancreatic cancer.Radiation oncology (London, England) · 2021Article
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Authors and funding
19 authors at 3 institutions in 4 countries.
Funding
Abstract
backgroundThe introduction of multi-agent chemotherapy and radiation therapy has facilitated potential resection with curative intent in selected locally advanced pancreatic cancer (LAPC) patients with excellent outcomes. Nevertheless, there remains a remarkable lack of consensus on the management of LAPC. We sought to describe the outcomes of patients with LAPC and objectively define the multidisciplinary selection process for operative exploration based on anatomical factors.
methodsConsecutive patients with LAPC were evaluated for pancreatic surgery in the multidisciplinary clinic of a high-volume institution, between 2013 and 2018. Prospective stratification (LAPC-1, LAPC-2, and LAPC-3), based on the involvement of regional anatomical structures, was performed at the time of presentation prior to the initiation of treatment. Resection rates and patient outcomes were evaluated and correlated with the initial anatomic stratification system.
resultsOverall, 415 patients with LAPC were included in the study, of whom 84 (20%) were successfully resected, with a median overall survival of 35.3 months. The likelihood of operative exploration was associated with the pretreatment anatomic LAPC score, with a resection rate of 49% in patients classified as LAPC-1, 32% in LAPC-2, and 11% in LAPC-3 (p < 0.001). Resected patients with improvement of the LAPC score at the time of exploration had significantly longer median overall survival compared with those with no change or progression of LAPC score (60.7 vs. 29.8 months, p = 0.006).
conclusionsSelected patients with LAPC can undergo curative-intent surgery with excellent outcomes. The proposed Johns Hopkins anatomic LAPC score provides an objective system to anticipate the probability of eventual surgical resection after induction therapy.
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