| Title |
Downstaging in Stage IV Pancreatic Cancer: A New Population Eligible for Surgery?
|
|---|---|
| Published in |
Annals of Surgical Oncology, May 2017
|
| DOI | 10.1245/s10434-017-5885-4 |
| Pubmed ID | |
| Authors |
Isabella Frigerio, Paolo Regi, Alessandro Giardino, Filippo Scopelliti, Roberto Girelli, Claudio Bassi, Stefano Gobbo, Paolo Tinazzi Martini, Paola Capelli, Mirko D’Onofrio, Giuseppe Malleo, Laura Maggino, Elena Viviani, Giovanni Butturini |
| Abstract |
Recent papers consider surgery as an option for synchronous liver oligometastatic patients [metastatic pancreatic ductal adenocarcinoma (mPDAC)]. In this study, we present our series of resected mPDACs after neoadjuvant chemotherapy (nCT). All patients resected after downstaging of mPDAC were included in this study. Downstaging criteria were disappearance of liver metastasis and a decrease in cancer antigen (CA) 19-9. The type and duration of nCT, last nCT surgery interval, histology, morbidity, and mortality were recorded, and overall survival (OS) and disease-free survival (DFS) were analyzed. Overall, 24 of 535 patients (4.5%) observed with mPDAC were included. These patients received gemcitabine alone (5/24), gemcitabine + nanoparticle albumin-bound (nab)-paclitaxel (3/24), and FOLFIRINOX (16/24). Primary tumor size decreased from 31 to 19 mm (p < 0.001), and serum CA19-9 decreased from 596 to 18 U/mL (p < 0.001). In 14/24 patients, the tumor was located in the head. Median interval nCT surgery was 2 months, there were no mortalities, and the postoperative course was uneventful in 34% of cases. Grade B/C pancreatic fistula, postoperative bleeding, and sepsis occurred in 17/4, 4, and 12% of cases, respectively, and reoperation rate was 4%. R0 resection was achieved in 88% of cases, with 17% complete pathological response. Positive nodes were found in 9/24 patients with a median node ratio of 0.37, and OS and DFS was 56 and 27 months, respectively. Patients with mPDAC who were fully responsive to nCT may be cautiously considered for surgery, with potential benefit in survival compared with palliative chemotherapy alone. This is supported by results of our retrospective study, which is the largest ever reported. |
X Demographics
The data shown below were collected from the profiles of 16 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 25% |
| Poland | 1 | 6% |
| United Kingdom | 1 | 6% |
| Saudi Arabia | 1 | 6% |
| Australia | 1 | 6% |
| Panama | 1 | 6% |
| Lebanon | 1 | 6% |
| Unknown | 6 | 38% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 63% |
| Scientists | 4 | 25% |
| Practitioners (doctors, other healthcare professionals) | 2 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 69 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 69 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 14 | 20% |
| Other | 7 | 10% |
| Student > Ph. D. Student | 7 | 10% |
| Student > Master | 7 | 10% |
| Student > Bachelor | 6 | 9% |
| Other | 12 | 17% |
| Unknown | 16 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 41 | 59% |
| Unspecified | 1 | 1% |
| Biochemistry, Genetics and Molecular Biology | 1 | 1% |
| Arts and Humanities | 1 | 1% |
| Agricultural and Biological Sciences | 1 | 1% |
| Other | 3 | 4% |
| Unknown | 21 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 June 2018.
All research outputs
#2,959,141
of 22,973,051 outputs
Outputs from Annals of Surgical Oncology
#820
of 6,520 outputs
Outputs of similar age
#56,489
of 313,742 outputs
Outputs of similar age from Annals of Surgical Oncology
#8
of 57 outputs
Altmetric has tracked 22,973,051 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,520 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 313,742 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 81% of its contemporaries.
We're also able to compare this research output to 57 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 85% of its contemporaries.