Added value of intra-operative ultrasound to determine the resectability of locally advanced pancreatic cancer following FOLFIRINOX chemotherapy (IMAGE): a prospective multicenter study

Dutch Pancreatic Cancer Group, Eran van Veldhuisen, Marieke S. Walma, L. Bengt van Rijssen, Olivier R. Busch, Rutger C. G. Bruijnen, Otto M. van Delden, Nadia Haj Mohammad, Ignace H. de Hingh, Lonneke S. Yo, Hanneke W. van Laarhoven, Maarten S. van Leeuwen, C. Yung Nio, Hjalmar C. van Santvoort, Jan de Vries, Frank J. Wessels, Johanna W. Wilmink, I. Quintus Molenaar, Marc G. Besselink, Krijn P. van Lienden

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Determining the resectability of locally advanced pancreatic cancer (LAPC) after FOLFIRINOX chemotherapy is challenging because CT-scans cannot reliably assess vascular involvement. This study evaluates the added value of intra-operative ultrasound (IOUS) in LAPC following FOLFIRINOX induction chemotherapy. Methods: Prospective multicenter study in patients with LAPC who underwent explorative laparotomy with IOUS after FOLFIRINOX chemotherapy. Resectability was defined according to the National Comprehensive Cancer Network guidelines. IOUS findings were compared with preoperative CT-scans and pathology results. Results: CT-staging in 38 patients with LAPC after FOLFIRINOX chemotherapy defined 22 patients LAPC, 15 borderline resectable and one resectable. IOUS defined 19 patients LAPC, 13 borderline resectable and six resectable. In 12/38 patients, IOUS changed the resectability status including five patients from borderline resectable to resectable and five patients from LAPC to borderline resectable. Two patients were upstaged from borderline resectable to LAPC. Tumor diameters were significantly smaller upon IOUS (31.7 ± 9.5 mm versus 37.1 ± 10.0 mm, p = 0.001) and resectability varied significantly (p = 0.043). Ultimately, 20 patients underwent resection of whom 14 were evaluated as (borderline) resectable on CT-scan, and 17 on IOUS. Discussion: This prospective study demonstrates that IOUS may change the resectability status up to a third of patients with LAPC following FOLFIRINOX chemotherapy.
LanguageEnglish
JournalHPB
DOIs
Publication statusPublished - 2019

Cite this

@article{6683ef0edfec4118ae60a2ced93136d5,
title = "Added value of intra-operative ultrasound to determine the resectability of locally advanced pancreatic cancer following FOLFIRINOX chemotherapy (IMAGE): a prospective multicenter study",
abstract = "Background: Determining the resectability of locally advanced pancreatic cancer (LAPC) after FOLFIRINOX chemotherapy is challenging because CT-scans cannot reliably assess vascular involvement. This study evaluates the added value of intra-operative ultrasound (IOUS) in LAPC following FOLFIRINOX induction chemotherapy. Methods: Prospective multicenter study in patients with LAPC who underwent explorative laparotomy with IOUS after FOLFIRINOX chemotherapy. Resectability was defined according to the National Comprehensive Cancer Network guidelines. IOUS findings were compared with preoperative CT-scans and pathology results. Results: CT-staging in 38 patients with LAPC after FOLFIRINOX chemotherapy defined 22 patients LAPC, 15 borderline resectable and one resectable. IOUS defined 19 patients LAPC, 13 borderline resectable and six resectable. In 12/38 patients, IOUS changed the resectability status including five patients from borderline resectable to resectable and five patients from LAPC to borderline resectable. Two patients were upstaged from borderline resectable to LAPC. Tumor diameters were significantly smaller upon IOUS (31.7 ± 9.5 mm versus 37.1 ± 10.0 mm, p = 0.001) and resectability varied significantly (p = 0.043). Ultimately, 20 patients underwent resection of whom 14 were evaluated as (borderline) resectable on CT-scan, and 17 on IOUS. Discussion: This prospective study demonstrates that IOUS may change the resectability status up to a third of patients with LAPC following FOLFIRINOX chemotherapy.",
author = "{Dutch Pancreatic Cancer Group} and {van Veldhuisen}, Eran and Walma, {Marieke S.} and {van Rijssen}, {L. Bengt} and Busch, {Olivier R.} and Bruijnen, {Rutger C. G.} and {van Delden}, {Otto M.} and Mohammad, {Nadia Haj} and {de Hingh}, {Ignace H.} and Yo, {Lonneke S.} and {van Laarhoven}, {Hanneke W.} and {van Leeuwen}, {Maarten S.} and Nio, {C. Yung} and {van Santvoort}, {Hjalmar C.} and {de Vries}, Jan and Wessels, {Frank J.} and Wilmink, {Johanna W.} and Molenaar, {I. Quintus} and Besselink, {Marc G.} and {van Lienden}, {Krijn P.}",
year = "2019",
doi = "10.1016/j.hpb.2019.02.017",
language = "English",
journal = "HPB",
issn = "1477-2574",
publisher = "John Wiley and Sons Inc.",

}

Added value of intra-operative ultrasound to determine the resectability of locally advanced pancreatic cancer following FOLFIRINOX chemotherapy (IMAGE): a prospective multicenter study. / Dutch Pancreatic Cancer Group.

In: HPB, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Added value of intra-operative ultrasound to determine the resectability of locally advanced pancreatic cancer following FOLFIRINOX chemotherapy (IMAGE): a prospective multicenter study

AU - Dutch Pancreatic Cancer Group

AU - van Veldhuisen, Eran

AU - Walma, Marieke S.

AU - van Rijssen, L. Bengt

AU - Busch, Olivier R.

AU - Bruijnen, Rutger C. G.

AU - van Delden, Otto M.

AU - Mohammad, Nadia Haj

AU - de Hingh, Ignace H.

AU - Yo, Lonneke S.

AU - van Laarhoven, Hanneke W.

AU - van Leeuwen, Maarten S.

AU - Nio, C. Yung

AU - van Santvoort, Hjalmar C.

AU - de Vries, Jan

AU - Wessels, Frank J.

AU - Wilmink, Johanna W.

AU - Molenaar, I. Quintus

AU - Besselink, Marc G.

AU - van Lienden, Krijn P.

PY - 2019

Y1 - 2019

N2 - Background: Determining the resectability of locally advanced pancreatic cancer (LAPC) after FOLFIRINOX chemotherapy is challenging because CT-scans cannot reliably assess vascular involvement. This study evaluates the added value of intra-operative ultrasound (IOUS) in LAPC following FOLFIRINOX induction chemotherapy. Methods: Prospective multicenter study in patients with LAPC who underwent explorative laparotomy with IOUS after FOLFIRINOX chemotherapy. Resectability was defined according to the National Comprehensive Cancer Network guidelines. IOUS findings were compared with preoperative CT-scans and pathology results. Results: CT-staging in 38 patients with LAPC after FOLFIRINOX chemotherapy defined 22 patients LAPC, 15 borderline resectable and one resectable. IOUS defined 19 patients LAPC, 13 borderline resectable and six resectable. In 12/38 patients, IOUS changed the resectability status including five patients from borderline resectable to resectable and five patients from LAPC to borderline resectable. Two patients were upstaged from borderline resectable to LAPC. Tumor diameters were significantly smaller upon IOUS (31.7 ± 9.5 mm versus 37.1 ± 10.0 mm, p = 0.001) and resectability varied significantly (p = 0.043). Ultimately, 20 patients underwent resection of whom 14 were evaluated as (borderline) resectable on CT-scan, and 17 on IOUS. Discussion: This prospective study demonstrates that IOUS may change the resectability status up to a third of patients with LAPC following FOLFIRINOX chemotherapy.

AB - Background: Determining the resectability of locally advanced pancreatic cancer (LAPC) after FOLFIRINOX chemotherapy is challenging because CT-scans cannot reliably assess vascular involvement. This study evaluates the added value of intra-operative ultrasound (IOUS) in LAPC following FOLFIRINOX induction chemotherapy. Methods: Prospective multicenter study in patients with LAPC who underwent explorative laparotomy with IOUS after FOLFIRINOX chemotherapy. Resectability was defined according to the National Comprehensive Cancer Network guidelines. IOUS findings were compared with preoperative CT-scans and pathology results. Results: CT-staging in 38 patients with LAPC after FOLFIRINOX chemotherapy defined 22 patients LAPC, 15 borderline resectable and one resectable. IOUS defined 19 patients LAPC, 13 borderline resectable and six resectable. In 12/38 patients, IOUS changed the resectability status including five patients from borderline resectable to resectable and five patients from LAPC to borderline resectable. Two patients were upstaged from borderline resectable to LAPC. Tumor diameters were significantly smaller upon IOUS (31.7 ± 9.5 mm versus 37.1 ± 10.0 mm, p = 0.001) and resectability varied significantly (p = 0.043). Ultimately, 20 patients underwent resection of whom 14 were evaluated as (borderline) resectable on CT-scan, and 17 on IOUS. Discussion: This prospective study demonstrates that IOUS may change the resectability status up to a third of patients with LAPC following FOLFIRINOX chemotherapy.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064406987&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31010633

U2 - 10.1016/j.hpb.2019.02.017

DO - 10.1016/j.hpb.2019.02.017

M3 - Article

JO - HPB

T2 - HPB

JF - HPB

SN - 1477-2574

ER -