Evidence map›Paper›PMID 42081099›Full record

ArticleJournal of gastroenterology2026

Conversion surgery for unresectable pancreatic ductal adenocarcinoma with liver metastasis at initial diagnosis: a nationwide multicenter study.

Daisuke Hashimoto, Tsukasa Ikeura, Aya Maekawa, Takayoshi Nakajima, Keinosuke Ishido, Aoi Hayasaki, Toshimichi Asano, Masamichi Hayashi, Isaku Yoshioka, Hiromichi Ishii and 35 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

45 authors.

Daisuke HashimotoDepartment of Pancreatobiliary Surgery, Kansai Medical University, Hirakata, Japan.
Tsukasa IkeuraThird Department of Internal Medicine, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan. ikeurat@hirakata.kmu.ac.jp.ORCID http://orcid.org/0000-0002-0241-2821
Aya MaekawaDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto City, Japan.
Takayoshi NakajimaDepartment of Surgery, Meiwa Hospital, Nishinomiya, Japan.
Keinosuke IshidoDepartment of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Aoi HayasakiDepartment of Hepatobiliary Pancreatic and Transplant Surgery, Mie University, Tsu, Japan.
Toshimichi AsanoDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
Masamichi HayashiDepartment of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Isaku YoshiokaDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
Hiromichi IshiiDepartment of Surgery, Matsushita Memorial Hospital, Moriguchi, Japan.
Akifumi KimuraDepartment of Hepato- Biliary- Pancreatic Surgery and Pediatric Surgery, Saitama Medical University, Saitama, Japan.
Hideki MotobayashiSecond Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Masaaki MurakawaDepartment of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Kenjiro OkadaDepartment of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Higashihiroshima, Japan.
Toshiya AbeDepartment of Surgery and Oncology, Kyushu University, Fukuoka, Japan.
Yoshiki HirookaDepartment of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Japan.
Masafumi ImamuraDivision of Gastroenterological Surgery, Department of Surgery, Sapporo Medical University, Sapporo, Japan.
Keiko KameiDepartment of Surgery, Faculty of Medicine, Kindai University, Higashiosaka, Japan.
Shogo KobayashiDepartment of Gastroenterological Surgery, Osaka University, Suita, Japan.
Toru MaruoDepartment of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan.
Joe MatsumotoDepartment of General Surgery, Tonan Hospital, Sapporo, Japan.
Katsuyuki MiyabeDepartment of Gastroenterology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan.
Minako NagaiDepartment of Surgery, Nara Medical University, Kashihara, Japan.
Shinsuke NakashimaDepartment of Gastroenterological Surgery, Higashiosaka City Medical Center, Higashiosaka, Japan.
Yoshitaro ShindoDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Makoto ShinzekiDepartment of Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Shuji SuzukiDepartment of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.
Tatsunori SuzukiDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Japan.
Masayuki TanakaDepartment of Surgery, Keio University School of Medicine, Shinjuku City, Japan.
Satoshi TannoDepartment of Gastroenterology, IMS Sapporo Digestive Disease Center General Hospital, Sapporo, Japan.
Tomoyuki YokotaCenter for Liver - Biliary - Pancreatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Japan.
Kenta MurotaniBiostatistics Center, Kurume University, Kurume, Japan.
Yousuke NakaiDepartment of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku City, Japan.
Yosuke InoueDivision of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto City, Japan.
Masamichi MizumaDepartment of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Michiaki UnnoDepartment of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ippei MatsumotoDepartment of Surgery, Faculty of Medicine, Kindai University, Higashiosaka, Japan.
Tsutomu FujiiDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
Kenichiro UemuraDepartment of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Higashihiroshima, Japan.
Masayuki ShoDepartment of Surgery, Nara Medical University, Kashihara, Japan.
Satoshi HiranoDepartment of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
Sohei SatoiDepartment of Pancreatobiliary Surgery, Kansai Medical University, Hirakata, Japan.
Atsushi MasamuneDivision of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yoshifumi TakeyamaDepartment of Surgery, Faculty of Medicine, Kindai University, Higashiosaka, Japan.
A project study group of the Japan Pancreas Society

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith recent advances in chemotherapy for unresectable pancreatic ductal adenocarcinoma (PDAC) with liver metastasis (LM), attempts have been made to resect the primary tumor in patients showing favorable responses to anti-cancer treatment (so-called "conversion surgery"; CS). This study aimed to clarify the outcomes of CS for PDAC with LM in a nationwide multicenter study.

methodsThis retrospective, multicenter study was conducted as a project study of the Japan Pancreas Society and included patients with PDAC with LM at initial diagnosis, diagnosed radiologically or intraoperatively (occult LM), who underwent CS after at least 4 months of chemotherapy between 2010 and 2022. Survival outcomes and prognostic factors were analyzed.

results90 patients were enrolled from 31 Japanese institutions. Median duration of preoperative chemotherapy was 10.4 (range, 4.2-58.5) months, and gemcitabine plus nab-paclitaxel was the most common first-line regimen, followed by folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin. Liver metastasectomy was performed in 27 patients (30%). 82 patients (91.1%) initiated adjuvant chemotherapy, and 41 (45.6%) completed it. Overall survival (OS) from initial treatment was 53.1 (95% CI 41.6-65.7) months; OS after CS was 39.7 (95% CI 24.4-55.9) months, and disease-free survival was 14.7 (95% CI 9.3-23.4) months. Preoperative normalization of carbohydrate antigen 19-9 and pathologic negative lymph node metastasis were independent prognostic factors for OS.

conclusionCS may provide a survival benefit for highly selected patients with PDAC and LM, including those with occult lesions, who respond well to multidisciplinary treatment.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalLiver NeoplasmsPancreatic NeoplasmsAdultAgedAged, 80 and overChemotherapy, AdjuvantFemaleHumansJapanMaleMetastasectomyMiddle AgedPrognosisRetrospective StudiesChemotherapyConversion surgeryLiver metastasisPancreatic ductal adenocarcinoma

Identifiers

PMID42081099

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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.