dc.contributor.author
Rosumeck, Nathalie
dc.contributor.author
Timmermann, Lea
dc.contributor.author
Klein, Fritz
dc.contributor.author
Bahra, Marcus
dc.contributor.author
Stintzig, Sebastian
dc.contributor.author
Malinka, Thomas
dc.contributor.author
Pelzer, Uwe
dc.date.accessioned
2021-09-30T15:02:22Z
dc.date.available
2021-09-30T15:02:22Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/32147
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-31875
dc.description.abstract
Background and Objectives: An increasing number of patients (pts) with locally advanced pancreatic cancer (LAPC) are treated with an intensive neoadjuvant therapy to obtain a secondary curative resection. Only a certain number of patients benefit from this intention. The aim of this investigation was to identify prognostic factors which may predict a benefit for secondary resection. Materials and Methods: Survival time and clinicopathological data of pts with pancreatic cancer were prospective and consecutively collected in our Comprehensive Cancer Center Database. For this investigation, we screened for pts with primarily unresectable pancreatic cancer who underwent a secondary resection after receiving induction therapy in the time between March 2017 and May 2019. Results: 40 pts had a sufficient database to carry out a reliable analysis. The carbohydrate-antigen 19-9 (CA 19-9) level of the pts treated with induction therapy decreased by 44.7% from 4358.3 U/mL to 138.5 U/mL (p = 0.001). The local cancer extension was significantly reduced (p < 0.001), and the Eastern Cooperative Oncology Group (ECOG) performance status was lowered (p = 0.03). The median overall survival (mOS) was 20 months (95% CI: 17.2-22.9). Pts who showed a normal CA 19-9 level (<37 U/mL) at diagnosis and after neoadjuvant therapy or had a Body Mass Index (BMI) below 25 kg/m(2) after chemotherapy had a significant prolonged overall survival (29 vs. 19 months, p = 0.02; 26 vs. 18 months, p = 0.04; 15 vs. 24 months, p = 0.01). Pts who still presented elevated CA 19-9 levels >400 U/mL after induction therapy did not profit from a secondary resection (24 vs. 7 months, p < 0.001). Nodal negativity as well as the performance of an adjuvant therapy lead to better mOS (25 vs. 15 months, p = 0.003; 10 vs. 25 months, p < 0.001). Conclusion: The pts in our investigation had different benefits from the multimodal treatment. We identified the CA 19-9 level at time of diagnosis and after neoadjuvant therapy as well as the preoperative BMI as predictive factors for overall survival. Furthermore, diagnostics of presurgical nodal status should gain more importance as nodal negativity is associated with better outcome.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
pancreatic cancer
en
dc.subject
neoadjuvant therapy
en
dc.subject
induction therapy
en
dc.subject
secondary resection
en
dc.subject
pancreatic surgery
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Induction Chemotherapy for Primarily Unresectable Locally Advanced Pancreatic Adenocarcinoma—Who Will Benefit from a Secondary Resection?
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
77
dcterms.bibliographicCitation.doi
10.3390/medicina57010077
dcterms.bibliographicCitation.journaltitle
Medicina
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
MDPI AG
dcterms.bibliographicCitation.volume
57
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
33477505
dcterms.isPartOf.eissn
1648-9144