Evidence map›Paper›PMID 40792645›Full record

ArticleAnnals of surgery2025

Surgical Complications in Patients with (borderline) Resectable Pancreatic Cancer after Neoadjuvant Therapy in the PREOPANC-2 Randomized Controlled Trial.

Esther N Dekker, Rutger T Theijse, Jacob L van Dam, Quisette P Janssen, Thomas F Stoop, Bert A Bonsing, Koop P Bosscha, Stefan A W Bouwense, Olivier R Busch, Peter-Paul L O Coene and 21 more

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Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors.

Esther N DekkerDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.ORCID 0000-0002-3040-6736
Rutger T TheijseAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Jacob L van DamDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Quisette P JanssenDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Thomas F StoopAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Bert A BonsingDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Koop P BosschaDepartment of Surgery, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
Stefan A W BouwenseDepartment of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht UMC+, Maastricht, the Netherlands.
Olivier R BuschAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Peter-Paul L O CoeneDepartment of Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
Casper H J van EijckDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Erwin van Her HarstDepartment of Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
Ignace H J T de HinghDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
Tom M KarstenDepartment of Surgery, OLVG, Amsterdam, the Netherlands.
Geert KazemierAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Marion B van der KolkDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Mike S L LiemDepartment of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
J Sven D MieogDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Vincent B NieuwenhuijsDepartment of Surgery, Isala Oncology Center, Zwolle, The Netherlands.
Gijs A PatijnDepartment of Surgery, Isala Oncology Center, Zwolle, The Netherlands.
Hjalmar C van SantvoortDepartment of Surgery, Regional Academic Cancer Center Utrecht, St. Antonius Hospital and University Medical Center Utrecht, Utrecht, the Netherlands.
Jennifer M J SchreinemakersDepartment of Surgery, Amphia Hospital, Breda, The Netherlands.
Roeland F de WildeDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Fennie WitDepartment of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Babs M ZonderhuisAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Marjolein Y V HomsDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Geertjan van TienhovenCancer Center Amsterdam, the Netherlands.
Johanna W WilminkCancer Center Amsterdam, the Netherlands.
Marc G BesselinkAmsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Bas Groot KoerkampDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Dutch Pancreatic Cancer Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the incidence of major surgical complications between patients with (borderline) resectable pancreatic cancer treated with neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy. SUMMARY OF BACKGROUND DATA: There are ongoing concerns regarding the possible adverse impact of neoadjuvant treatment on postoperative complication rates following pancreatectomy.

methodsThis study was a predefined analysis within the investigator-initiated nationwide randomized controlled PREOPANC-2 trial. Patients with (borderline) resectable pancreatic cancer were randomized to receive neoadjuvant FOLFIRINOX (FFX group) or neoadjuvant gemcitabine-based chemoradiotherapy (CRT group), both followed by surgery, and adjuvant gemcitabine only in the CRT group. Surgical complications including postoperative pancreatic fistula, postpancreatectomy hemorrhage, bile leakage, postoperative interventions, and 90-day mortality were compared, with major complications defined as Clavien-Dindo grade ≥3.

resultsBetween June 5, 2018, and January 28, 2021, in total 375 patients were randomized, of whom 280 (74.7%) underwent pancreatic resection. A pancreatoduodenectomy was performed in 238 patients (85.0%), left pancreatectomy in 41 patients (14.6%), and total pancreatectomy in one patient (0.4%). The incidence of major surgical complications was similar between the FFX and CRT groups (26.8% versus 27.5%, P=0.884). No differences were observed in the risk of postoperative pancreatic fistula grade B/C (9.9% versus 4.4%, P=0.076), postpancreatectomy hemorrhage grade B/C (7.7% versus 3.6%, P=0.137), bile leakage grade B/C (2.5% versus 2.5%, P>0.999), and postoperative interventions (26.1% versus 26.8%, P=0.886). Surgical reoperation was performed in nine patients (6.3%) in the FFX group and eight patients (5.8%) in the CRT group (P=0.850). The postoperative 90-day mortality was 1.4% in the FFX group (2/142 patients) and 2.9% in the CRT group (4/138 patients) (P=0.442).

conclusionsIn the PREOPANC-2 randomized trial, the risk of major surgical complications after pancreatic resection following neoadjuvant FOLFIRINOX or neoadjuvant gemcitabine-based chemoradiotherapy was similar with an overall low 90-day mortality.

Indexed as

investigator-initiatednationwidePDACPREOPANC-2RCTsurgical complications

Identifiers

PMID40792645

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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.