Evidence map›Paper›PMID 39847363›Full record

ArticleJAMA oncology2025

Adjuvant Chemotherapy After Resection of Localized Pancreatic Adenocarcinoma Following Preoperative FOLFIRINOX.

Thomas F Stoop, Toshitaka Sugawara, Atsushi Oba, Isabel M Feld, Stijn van Roessel, Eran van Veldhuisen, Y H Andrew Wu, Jo Nishino, Mahsoem Ali, Adnan Alseidi and 46 more

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Article in JAMA oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
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

11 citing papers in PubMed.

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  11. Errors in Results and Figure 2.JAMA oncology · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

56 authors.

Thomas F StoopDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Toshitaka SugawaraDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Atsushi ObaDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Isabel M FeldAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Stijn van RoesselAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Eran van VeldhuisenAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Y H Andrew WuDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Jo NishinoDivision of Bioinformatics, Research Institute National Cancer Center Japan, Tokyo, Japan.
Mahsoem AliAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Adnan AlseidiDepartment of Surgery, Virginia Mason Medical Center, Seattle, Washington.
Alain SauvanetDepartment of HPB Surgery and Liver Transplantation, Hôpital Beaujon, University Paris Cité, Clichy, France.
Antonello MirabellaGeneral Surgery Department, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
Antonio Sa CunhaDepartment of Hepato-Biliary-Pancreatic Surgery, Liver Transplant Center, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
Arto KokkolaDepartment of Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Bas Groot KoerkampDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Daniel PietraszDepartment of Hepato-Biliary-Pancreatic Surgery, Liver Transplant Center, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
Dyre KleiveDepartment of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Giovanni ButturiniDepartment of Surgery, Pederzoli Hospital, Peschiera, Italy.
Giuseppe MalleoDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
Hanneke W M van LaarhovenCancer Center Amsterdam, Amsterdam, the Netherlands.
Isabella FrigerioDepartment of Surgery, Pederzoli Hospital, Peschiera, Italy.
Jeanne DembinskiDepartment of HPB Surgery and Liver Transplantation, Hôpital Beaujon, University Paris Cité, Clichy, France.
Jin HeDivision of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Johan GagnièreDepartment of Digestive and Hepatobiliary Surgery-Liver Transplantation, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Jörg KleeffDepartment of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany.
Jose M RamiaDepartment of Surgery, Hospital General Universitario de Alicante, Alicante, Spain.
Keith J RobertsHepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom.
Knut J LaboriDepartment of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Marco V MarinoGeneral Surgery Department, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
Massimo FalconiDepartment of Pancreatic Surgery, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy.
Michael B MortensenDepartment of Surgery, Odense Pancreas Center, Odense University Hospital, Odense, Denmark.
Mickaël LesurtelDepartment of Hepato-Biliary-Pancreatic Surgery, Liver Transplant Center, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
Morgan BondsDepartment of Surgery, Virginia Mason Medical Center, Seattle, Washington.
Nikolaos ChatzizachariasHepato-Pancreato-Biliary Unit, Department of Surgery, University Hospitals of Birmingham, Birmingham, United Kingdom.
Oliver StrobelDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Olivier TurriniDepartment of Surgical Oncology, Aix-Marseille University, Institut Paoli-Calmettes, CRCM, Marseille, France.
Oonagh GriffinNational Surgical Center for Pancreatic Cancer, St. Vincent's University Hospital, Dublin, Ireland.
Oskar FranklinDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Per PfeifferDepartment of Oncology, Odense University Hospital, Odense, Denmark.
Richard D SchulickDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Roberto SalviaDepartment of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
Roeland F de WildeDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Safi DokmakDepartment of HPB Surgery and Liver Transplantation, Hôpital Beaujon, University Paris Cité, Clichy, France.
Salvador Rodriguez FrancoDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Simone AugustinusAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Stefan K BurgdorfDepartment of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Stefano CrippaDepartment of Pancreatic Surgery, IRCCS San Raffaele Hospital, Vita-Salute University, Milano, Italy.
Thilo HackertDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Timo TarvainenDepartment of Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
William R BurnsDivision of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Wells MessersmithDivision of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora.
Johanna W WilminkCancer Center Amsterdam, Amsterdam, the Netherlands.
Richard A BurkhartDivision of Hepatobiliary and Pancreatic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Marco Del ChiaroDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Marc G BesselinkAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Scientific Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) and International Collaboration on Advanced Pancreatic Cancer

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The effect of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX (combination leucovorin calcium [folinic acid], fluorouracil, irinotecan hydrochloride, and oxaliplatin in full or modified dosing) chemotherapy on overall survival (OS) is unclear because current studies do not account for the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen. Objective: To investigate the association of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX with OS, taking into account the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen. Design, Setting, and Participants: This retrospective cohort study included patients with localized pancreatic adenocarcinoma treated with 2 to 11 cycles of preoperative (m)FOLFIRINOX followed by resection across 48 centers in 20 countries from 2010 to 2018. Patients who died within 3 months after surgery were excluded (landmark). Data were analyzed from February 1 to December 31, 2023. Exposures: Preoperative (m)FOLFIRINOX chemotherapy followed by resection and eventually followed by adjuvant chemotherapy. Main Outcomes and Measures: The primary outcome was OS, calculated from the 3-month landmark. Cox regression analysis, including interaction analyses, was performed to investigate the association of adjuvant chemotherapy with OS. Results: Overall, 767 patients were included after resection of pancreatic adenocarcinoma (median [IQR] age, 62 [55-67] years; 404 [52.7%] male). Adjuvant chemotherapy was independently associated with prolonged OS (hazard ratio [HR], 0.66; 95% CI, 0.49-0.87), confirmed by adjusted OS curves. The interaction analysis to assess estimated treatment effect across subgroups was not statistically significant. The forest plot and interaction test suggest that the association of adjuvant chemotherapy was lower among patients receiving 8 or more cycles of preoperative (m)FOLFIRINOX, those who had radiological response, and those with ypN0 disease. Compared to no adjuvant chemotherapy, both adjuvant (m)FOLFIRINOX (HR, 0.57; 95% CI, 0.40-0.80) and other multiagent adjuvant regimens (HR, 0.61; 95% CI, 0.41-0.92) were associated with prolonged OS, whereas single-agent adjuvant chemotherapy was not (HR, 0.75; 95% CI, 0.55-1.03). Conclusions and Relevance: In this cohort study, adjuvant (m)FOLFIRINOX and other multiagent chemotherapy regimens were associated with improved OS following resection of localized pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX, whereas single-agent adjuvant chemotherapy was not. The impact of adjuvant chemotherapy on OS may be lower in subgroups such as patients with 8 or more preoperative cycles of (m)FOLFIRINOX, those having radiological response, and those with ypN0.

Indexed as

AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsPancreatic NeoplasmsAdultAgedChemotherapy, AdjuvantFemaleFluorouracilHumansIrinotecanLeucovorinMaleMiddle AgedOxaliplatinRetrospective StudiesFluorouracilfolfirinoxIrinotecanLeucovorinOxaliplatin

Identifiers

PMID39847363
PMCPMC11926629

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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.