Stage Classification and Prognosis Assessment in Localized Pancreatic Cancer: It Takes Two to Tango
Menée à partir de données portant sur 1 835 patients atteints d'un adénocarcinome canalaire du pancréas de stade localisé et traités par chimiothérapie de type FOLFIRINOX (modifié ou non), cette étude évalue l'intérêt des paramètres ABC, basés sur la résécabilité de la tumeur (résécable, à la limite de la résécabilité ou stade localement avancé), le niveau sérique de l'antigène CA 19-9 et le statut de performance, pour améliorer la stadification de la maladie
Although the 5-year survival of patients diagnosed with localized pancreatic ductal adenocarcinoma (PDAC) has increased from 32% to 44% over the 2018-2023 period,1,2 predicting the probability of cure and selecting the optimal therapeutic strategy in individual patients remains extremely difficult. Anatomical disease extent, especially regarding vascular involvement, is mostly perceived as a technical challenge for the surgeon to achieve a R0 resection; similarly, patient's performance status (PS) and comorbidities are perceived as factors altering the risk/benefit ratio of surgical intervention. Other factors, such as duration of symptoms and carbohydrate antigen (CA) 19-9 levels, are usually considered a proxy for risk of occult disease dissemination, potentially nullifying the curative potential of surgery.
Journal of Clinical Oncology , éditorial en libre accès, 2023