Surgery after FOLFIRINOX treatment for locally advanced and borderline resectable pancreatic cancer: increase in tumour attenuation on CT correlates with R0 resection

摘要: To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment FOLFIRINOX. Patients either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration FOLFIRINOX were retrospectively enrolled. Two radiologists reviewed the CT blinded to final outcome assessed chemotherapy response resectability. then divided into R0 resected (group A) not resected/R1 B), which compared. Of 59 patients included, 19 defined as unresectable (32%), 33 (56%) 7 (12%) during blind radiological evaluation Once in a setting, 27% non-resectable, whereas 73% received 70% rate. Consequent sensitivity specificity 86% 29%. At imaging review, significant decreases longest tumour dimension observed both groups: from 32 mm (95% CI 15–55) 21 (10–44) group A 34 (18–70) 26 (7–60) B, p < 0.05. However, increase attenuation all phases was only for resected, 52 HU (26–75) 65 (35–92) arterial phase (p 0.001) 62 (36–96) 78 (40–120) venous = 0.001). After neoadjuvant FOLFIRINOX, predicted resectability acceptable but low specificity. The observation increased at scan might represent reliable predictor resection. • drives assessment FOLFIRINOX predicts specificity Significant PDAC Tumour represents