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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2018

01-12-2018 | ASO Author Reflections

ASO Author Reflections: Neoadjuvant Therapy Versus Upfront Resection for Pancreatic Cancer

Authors: Stefano Andrianello, MD, Giovanni Marchegiani, MD, PhD, Roberto Salvia, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2018

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Excerpt

The introduction of FOLFIRINOX1 and nab-paclitaxel2 radically changed the natural history of pancreatic ductal adenocarcinoma (PDAC). Soon after demonstrating the positive effect in improving survival in metastatic disease, several pieces of evidence about their use in the neoadjuvant setting for locally advanced and borderline-resectable PDAC have been collected.3 In addition to the ability to reduce local disease burden, neoadjuvant therapy (NAT) has also been associated with improved surgical outcome. Patients undergoing pancreaticoduodenectomy (PD) after FOLFIRINOX, in particular, show an incredibly low rate of pancreatic fistula due to the fibrotic changes of the pancreatic stump found at surgery.4 All these promising results are pushing towards increasingly widespread use of NAT, even in case of resectable PDAC. …
Literature
1.
Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2013;364(19):1817–25.CrossRef
2.
Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691–703.CrossRef
3.
4.
Ferrone CR, Marchegiani G, Hong TS, et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer. Ann Surg. 2015;261(1):12–7.CrossRefPubMed
5.
Marchegiani G, Andrianello S, Nessi C, et al. Neoadjuvant therapy versus upfront resection for pancreatic cancer: the actual spectrum and clinical burden of postoperative complications. Ann Surg Oncol. 2018; 25(3):626–37.CrossRefPubMed
Metadata
Title
ASO Author Reflections: Neoadjuvant Therapy Versus Upfront Resection for Pancreatic Cancer
Authors
Stefano Andrianello, MD
Giovanni Marchegiani, MD, PhD
Roberto Salvia, MD, PhD
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6874-y

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