Preoperative Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Results of the Dutch Randomized Phase III PREOPANC Trial.

@article{Versteijne2020PreoperativeCV,
  title={Preoperative Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Results of the Dutch Randomized Phase III PREOPANC Trial.},
  author={E. Versteijne and M. Suker and Karin B. C. Groothuis and J. M. Akkermans-Vogelaar and M. Besselink and B. Bonsing and J. Buijsen and O. Busch and G. Creemers and R. V. Van Dam and F. Eskens and S. Festen and J. D. de Groot and B. Groot Koerkamp and I. D. de Hingh and M. Homs and J. V. van Hooft and E. Kerver and S. Luelmo and K. Neelis and J. Nuyttens and G. Paardekooper and G. Patijn and M. V. D. van der Sangen and J. de Vos-Geelen and J. Wilmink and A. Zwinderman and C. Punt and C. V. van Eijck and G. Van tienhoven},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  year={2020},
  pages={
          JCO1902274
        }
}
PURPOSE Preoperative chemoradiotherapy may improve the radical resection rate for resectable or borderline resectable pancreatic cancer, but the overall benefit is unproven. PATIENTS AND METHODS In this randomized phase III trial in 16 centers, patients with resectable or borderline resectable pancreatic cancer were randomly assigned to receive preoperative chemoradiotherapy, which consisted of 3 courses of gemcitabine, the second combined with 15 × 2.4 Gy radiotherapy, followed by surgery… Expand
Surgical Complications in a Multicenter Randomized Trial Comparing Preoperative Chemoradiotherapy and Immediate Surgery in Patients With Resectable and Borderline Resectable Pancreatic Cancer (PREOPANC Trial).
TLDR
Preoperative chemoradiotherapy did not increase the incidence of surgical complications or mortality and reduced the rate of postoperative pancreatic fistula after resection in patients with (borderline-)resectable pancreatic cancer. Expand
Total neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy and adjuvant gemcitabine for resectable and borderline resectable pancreatic cancer (PREOPANC-2 trial): study protocol for a nationwide multicenter randomized controlled trial
TLDR
The PREOPANC-2 trial investigates whether neoadjuvant FOLFIRINOX improves OS compared with neoadvuvant gemcitabine-based chemoradiotherapy and adjuvant gem citabine in resectables and borderline resectable pancreatic cancer patients. Expand
Neoadjuvant S-1 With Concurrent Radiotherapy Followed by Surgery for Borderline Resectable Pancreatic Cancer: A Phase II Open-Label Multicenter Prospective Trial (JASPAC05).
TLDR
S-1 and concurrent radiotherapy appear to be feasible and effective at increasing the R0 resection rate and improving survival in patients with BRPC. Expand
Neoadjuvant chemoradiation is associated with decreased lymph node ratio in borderline resectable pancreatic cancer: A propensity score matched analysis.
TLDR
NAT in BRPC was associated with more R0 and N0 resections and lower LNR compared to patients undergoing upfront resection for resectable disease. Expand
Added Value of Radiotherapy Following Neoadjuvant FOLFIRINOX for Resectable and Borderline Resectable Pancreatic Cancer: A Systematic Review and Meta-Analysis
TLDR
In this meta-analysis, radiotherapy following neoadjuvant FOLFIRINOX was associated with an improved R0 resection rate as compared with neoadJuvant F OLFIRinoX alone, but a difference in survival could not be demonstrated. Expand
Neoadjuvant treatment for borderline resectable pancreatic adenocarcinoma is associated with higher R0 rate compared to upfront surgery
TLDR
N NAT permitted a high R0 rate with a 0- or 1-mm clearance margin and was associated with better RFS and OS for patients with BRPC and in operated patients the NAT group achieved better R FS and OS than the US group. Expand
Evaluation of Adjuvant Chemotherapy in Patients With Resected Pancreatic Cancer After Neoadjuvant FOLFIRINOX Treatment.
TLDR
Adjuvant chemotherapy after neoadjuvant FOLFIRINOX and resection of pancreatic cancer was associated with improved survival only in patients with pathology-proven node-positive disease, and future randomized studies should be conducted to confirm this finding. Expand
Another Potential Benefit of Neoadjuvant Therapy in Pancreatic Cancer: Reduction in Postoperative Readmission Rates
TLDR
A retrospective review of patients with PDAC who underwent resection from 2004 to 2016 found that PDAC is a systemic disease, and multimodal treatment including surgery and chemotherapy is needed even in those with anatomically resectable disease. Expand
Optimal Upfront Treatment in Surgically Resectable Pancreatic Cancer Candidates: A High-Volume Center Retrospective Analysis
TLDR
Upfront surgery for certain patients with low volume disease may be suitable despite the global trend towards neoadjuvant chemotherapy for all upfront resectable patients, and both tumor viability and tumor grade were useful prognostic markers. Expand
Efficacy of Perioperative Chemotherapy for Resectable Pancreatic Adenocarcinoma: A Phase 2 Randomized Clinical Trial.
TLDR
This phase 2 randomized clinical trial did not demonstrate an improved OS with perioperative chemotherapy, compared with historical data from adjuvant trials in resectable pancreatic cancer. Expand
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