Impact of Different Primary Treatment Strategies on Recurrence-Focused Treatment of Pancreatic Ductal Adenocarcinoma
- 07.11.2025
- Pancreatic Tumors
- Verfasst von
- Paul C. M. Andel, MD
- Iris W. J. M. van Goor, MD, PhD
- Thijs J. Schouten, MD, PhD
- Marc G. Besselink, MD, PhD
- Bert A. Bonsing, MD, PhD
- Koop Bosscha, MD, PhD
- Olivier R. Busch, MD, PhD
- Geert A. Cirkel, MD, PhD
- Ronald M. van Dam, MD, PhD
- Sebastiaan Festen, MD, PhD
- Bas Groot Koerkamp, MD, PhD
- Erwin van der Harst, MD, PhD
- Ignace H. J. T. de Hingh, MD, PhD
- Martijn P. W. Intven, MD, PhD
- Geert Kazemier, MD, PhD
- Mike S. L. Liem, MD, PhD
- Maartje Los, MD, PhD
- Gert Meijer, MD, PhD
- Vincent E. de Meijer, MD, PhD
- Vincent B. Nieuwenhuijs, MD, PhD
- Daphne Roos, MD, PhD
- Jennifer M. J. Schreinemakers, MD, PhD
- Martijn W. J. Stommel, MD, PhD
- Fennie Wit, MD
- Robert C. Verdonk, MD, PhD
- Hjalmar C. van Santvoort, MD, PhD
- I. Quintus Molenaar, MD, PhD
- Lois A. Daamen, MD, PhD
- Vincent P. Groot, MD, PhD
- for the Dutch Pancreatic Cancer Group
- Erschienen in
- Annals of Surgical Oncology
Abstract
Background
Increased application of neoadjuvant therapy (NAT) and adjuvant therapy (AT) could limit treatment options for pancreatic ductal adenocarcinoma (PDAC) recurrence. This study aimed to identify patterns of recurrence-focused treatment and survival following different primary treatment strategies.
Methods
All patients who underwent PDAC resection in the Netherlands (2014–2019) were included. Patients were divided into five groups according to their primary treatment strategy: (1) resection only, (2) gemcitabine-based NAT + resection, (3) FOLFIRINOX-based NAT + resection, (4) resection + gemcitabine-based AT, and (5) resection + FOLFIRINOX-based AT. Differences in recurrence-focused treatment and post-recurrence survival (PRS) were assessed using multivariable logistic and Cox-proportional hazards analyses and were presented as odds ratios (ORs) and hazard ratios (HRs) with corresponding 95% confidence intervals (95% CIs), respectively.
Results
In total, 1739 patients (median follow-up of 51 [interquartile range 34–64] months) were included, of whom 1272 (73%) had disease recurrence. In these patients, recurrence-focused treatment was administered in 64/124 (52%) after FOLFIRINOX-based NAT compared with 74/410 (18%) with resection only (OR 4.13 [95% CI 3.34–5.12]; P<0.001), 29/70 (41%) with gemcitabine-based NAT (OR 1.61 [95% CI 1.21–2.15]; P<0.001), 239/604 (39%) with gemcitabine-based AT (OR 1.73 [95% CI 1.43–2.09]; P<0.001), and 24/64 (38%) with FOLFIRINOX-based AT (OR 1.44 [95% CI 1.06–1.95]; P=0.02). Recurrence-focused treatment was associated with a median PRS of 11 (95% CI 10–13) months compared with 3 (95% CI 2–3) months in patients with best supportive care (HR 0.31 [95% CI 0.26–0.37]; P<0.001).
Conclusions
Recurrence-focused treatment differs between patients with PDAC who received different primary treatment strategies and is associated with improved PRS.
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- Titel
- Impact of Different Primary Treatment Strategies on Recurrence-Focused Treatment of Pancreatic Ductal Adenocarcinoma
- Verfasst von
-
Paul C. M. Andel, MD
Iris W. J. M. van Goor, MD, PhD
Thijs J. Schouten, MD, PhD
Marc G. Besselink, MD, PhD
Bert A. Bonsing, MD, PhD
Koop Bosscha, MD, PhD
Olivier R. Busch, MD, PhD
Geert A. Cirkel, MD, PhD
Ronald M. van Dam, MD, PhD
Sebastiaan Festen, MD, PhD
Bas Groot Koerkamp, MD, PhD
Erwin van der Harst, MD, PhD
Ignace H. J. T. de Hingh, MD, PhD
Martijn P. W. Intven, MD, PhD
Geert Kazemier, MD, PhD
Mike S. L. Liem, MD, PhD
Maartje Los, MD, PhD
Gert Meijer, MD, PhD
Vincent E. de Meijer, MD, PhD
Vincent B. Nieuwenhuijs, MD, PhD
Daphne Roos, MD, PhD
Jennifer M. J. Schreinemakers, MD, PhD
Martijn W. J. Stommel, MD, PhD
Fennie Wit, MD
Robert C. Verdonk, MD, PhD
Hjalmar C. van Santvoort, MD, PhD
I. Quintus Molenaar, MD, PhD
Lois A. Daamen, MD, PhD
Vincent P. Groot, MD, PhD
for the Dutch Pancreatic Cancer Group
- Publikationsdatum
- 07.11.2025
- Verlag
- Springer International Publishing
- Erschienen in
-
Annals of Surgical Oncology
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681 - DOI
- https://doi.org/10.1245/s10434-025-18639-1
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