TY - JOUR
T1 - Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination
T2 - A multicenter retrospective study
AU - the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination
AU - Yamamoto, Tomohisa
AU - Shimokawa, Toshio
AU - Hayashi, Masamichi
AU - Mizuma, Masamichi
AU - Hirano, Katsuhisa
AU - Oba, Atsushi
AU - Asano, Toshimichi
AU - Miyato, Hideyo
AU - Yoshida, Makoto
AU - Matsumoto, Ippei
AU - Kawabata, Yasunari
AU - Sakamoto, Katsunori
AU - Motoi, Fuyuhiko
AU - Ishii, Shigeto
AU - Homma, Yuki
AU - Maehira, Hiromitsu
AU - Matsunaga, Yutaro
AU - Ikemoto, Tetsuya
AU - Nakamura, Masafumi
AU - Mataki, Yuko
AU - Notake, Tsuyoshi
AU - Akahoshi, Keiichi
AU - Takami, Hideki
AU - Yamaki, So
AU - Hashimoto, Daisuke
AU - Kimura, Yasutoshi
AU - Hirano, Satoshi
AU - Inoue, Yosuke
AU - Fujii, Tsutomu
AU - Unno, Michiaki
AU - Kodera, Yasuhiro
AU - Kitayama, Joji
AU - Satoi, Sohei
N1 - Publisher Copyright:
© 2025 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
PY - 2025
Y1 - 2025
N2 - Background: The effectiveness of intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) in pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal dissemination remains elusive. The aim of this study is to investigate the clinical outcome of patients treated with i.p.-PTX combined with systemic chemotherapy compared with current standard chemotherapy including gemcitabine plus nab-paclitaxel and FOLFIRINOX. Methods: Data of patients with peritoneal dissemination was retrospectively collected and analyzed (i.p.-PTX, n = 83; control, n = 86). Inverse probability of treatment-weighted analyses (IPTW) was used to balance baseline characteristics between two groups. Survival curves were estimated using Kaplan–Meier method, and the differences were compared using the log-rank test. Results: No significant differences were noted in overall survival (14.9 vs. 15.5 months, p = 0.481) and progression free survival (9.5 vs. 9.1 months, p = 0.267) between i.p.-PTX and the control groups. Nevertheless, i.p.-PTX (9.9 months) significantly prolonged the median progression-free survival (PFS) time compared with the control (8.6 months), among the matched patients using IPTW (hazard ratio 0.666, p = 0.041). Moreover, subgroup analysis among the patients whose primary tumor were evaluated either as resectable or borderline resectable disease revealed significantly better overall survival in the i.p.-PTX group compared with the control group (21.3 vs. 14.7 months, hazard ratio; 0.532, p = 0.033). Conversion surgery was more frequently performed in the i.p.-PTX group than the control group (24% vs. 4%, p = 0.006). Conclusion: The i.p. PTX regimen prolonged PFS but not overall survival, and subgroup analysis suggested the possibility of survival benefit in patients with occult peritoneal dissemination whose primary tumor was classified as resectable/borderline resectable disease.
AB - Background: The effectiveness of intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) in pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal dissemination remains elusive. The aim of this study is to investigate the clinical outcome of patients treated with i.p.-PTX combined with systemic chemotherapy compared with current standard chemotherapy including gemcitabine plus nab-paclitaxel and FOLFIRINOX. Methods: Data of patients with peritoneal dissemination was retrospectively collected and analyzed (i.p.-PTX, n = 83; control, n = 86). Inverse probability of treatment-weighted analyses (IPTW) was used to balance baseline characteristics between two groups. Survival curves were estimated using Kaplan–Meier method, and the differences were compared using the log-rank test. Results: No significant differences were noted in overall survival (14.9 vs. 15.5 months, p = 0.481) and progression free survival (9.5 vs. 9.1 months, p = 0.267) between i.p.-PTX and the control groups. Nevertheless, i.p.-PTX (9.9 months) significantly prolonged the median progression-free survival (PFS) time compared with the control (8.6 months), among the matched patients using IPTW (hazard ratio 0.666, p = 0.041). Moreover, subgroup analysis among the patients whose primary tumor were evaluated either as resectable or borderline resectable disease revealed significantly better overall survival in the i.p.-PTX group compared with the control group (21.3 vs. 14.7 months, hazard ratio; 0.532, p = 0.033). Conversion surgery was more frequently performed in the i.p.-PTX group than the control group (24% vs. 4%, p = 0.006). Conclusion: The i.p. PTX regimen prolonged PFS but not overall survival, and subgroup analysis suggested the possibility of survival benefit in patients with occult peritoneal dissemination whose primary tumor was classified as resectable/borderline resectable disease.
KW - intraperitoneal chemotherapy
KW - peritoneal dissemination
UR - http://www.scopus.com/inward/record.url?scp=86000235461&partnerID=8YFLogxK
U2 - 10.1002/ags3.70001
DO - 10.1002/ags3.70001
M3 - 学術論文
AN - SCOPUS:86000235461
SN - 2475-0328
JO - Annals of Gastroenterological Surgery
JF - Annals of Gastroenterological Surgery
ER -