Evidence map›Paper›PMID 37775737›Full record

ArticleBMC surgery2023

Predictive factors for survival in borderline resectable and locally advanced pancreatic cancer: are these really two different entities?

Luís Filipe Abreu de Carvalho, Filip Gryspeerdt, Niki Rashidian, Kobe Van Hove, Lambertine Maertens, Suzane Ribeiro, Anne Hoorens, Frederik Berrevoet

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Review
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

8 authors at 1 institution in 1 country.

Luís Filipe Abreu de CarvalhoDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. Luis.AbreudeCarvalho@UZGent.be.
Filip GryspeerdtDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Niki RashidianDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Kobe Van HoveDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Lambertine MaertensDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Suzane RibeiroDepartment of Gastroenterology, Division of Digestive Oncology, Ghent University Hospital, Ghent, Belgium.
Anne HoorensDepartment of Pathology, Ghent University Hospital, Ghent, Belgium.
Frederik BerrevoetDepartment of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Ghent University Hospital · BE

Funding

"Fonds voor Innovatie en Klinisch Onderzoek" from Ghent University hospital WBS KW/2196/ATH/001/001
6 · The paper itself

Abstract

backgroundThe treatment of borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) has evolved with a wider application of neoadjuvant chemotherapy (NACHT). The aim of this study was to identify predictive factors for survival in BR and LA PDAC.

methodsClinicopathologic data of patients with BR and LA PDAC who underwent surgical exploration between January 2011 and June 2021 were retrospectively collected. Survival from the date of surgery was estimated using the Kaplan-Meier method. Simple and multiple Cox proportional hazards models were fitted to identify factors associated with survival. Surgical resection was analyzed in combination with the involvement of lymph nodes as this last was only known after a formal resection.

resultsNinety patients were surgically explored (BR: 45, LA: 45), of which 51 (57%) were resected (BR: 31, LA: 20). NACHT was administered to 43 patients with FOLFIRINOX being the most frequent regimen applied (33/43, 77%). Major complications (Clavien-Dindo grade III and IV) occurred in 7.8% of patients and 90-day mortality rate was 3.3%. The median overall survival since surgery was 16 months (95% CI 12-20) in the group which underwent surgical resection and 10 months (95% CI 7-13) in the group with an unresectable tumor (p=0.001). Cox proportional hazards models showed significantly lower mortality hazard for surgical resection compared to no surgical resection, even after adjusting for National Comprehensive Cancer Network  (NCCN) classification and administration of NACHT [surgical resection with involved lymph nodes vs no surgical resection (cHR 0.49; 95% CI 0.29-0.82; p=0.007)]. There was no significant difference in survival between patients with BR and LA disease (cHR= 1.01; 95% CI 0.63-1.62; p=0.98).

conclusionsSurgical resection is the only predictor of survival in patients with BR and LA PDAC, regardless of their initial classification as BR or LA. Our results suggest that surgery should not be denied to patients with LA PDAC a priori. Prospective studies including patients from the moment of diagnosis are required to identify biologic and molecular markers which may allow a better selection of patients who will benefit from surgery.

Indexed as

Carcinoma, Pancreatic DuctalPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsFluorouracilHumansNeoadjuvant TherapyProspective StudiesRetrospective StudiesFluorouracilBorderline resectable pancreatic cancerFOLFIRINOXLocally advanced pancreatic cancerNeoadjuvant chemotherapyPancreatic cancer

Identifiers

PMID37775737
PMCPMC10541717
OpenAlexW4387159432

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.