Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study
Abstract 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...
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2025-07-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.70001 |
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| author | Tomohisa Yamamoto Toshio Shimokawa Masamichi Hayashi Masamichi Mizuma Katsuhisa Hirano Atsushi Oba Toshimichi Asano Hideyo Miyato Makoto Yoshida Ippei Matsumoto Yasunari Kawabata Katsunori Sakamoto Fuyuhiko Motoi Shigeto Ishii Yuki Homma Hiromitsu Maehira Yutaro Matsunaga Tetsuya Ikemoto Masafumi Nakamura Yuko Mataki Tsuyoshi Notake Keiichi Akahoshi Hideki Takami So Yamaki Daisuke Hashimoto Yasutoshi Kimura Satoshi Hirano Yosuke Inoue Tsutomu Fujii Michiaki Unno Yasuhiro Kodera Joji Kitayama Sohei Satoi the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination |
| author_facet | Tomohisa Yamamoto Toshio Shimokawa Masamichi Hayashi Masamichi Mizuma Katsuhisa Hirano Atsushi Oba Toshimichi Asano Hideyo Miyato Makoto Yoshida Ippei Matsumoto Yasunari Kawabata Katsunori Sakamoto Fuyuhiko Motoi Shigeto Ishii Yuki Homma Hiromitsu Maehira Yutaro Matsunaga Tetsuya Ikemoto Masafumi Nakamura Yuko Mataki Tsuyoshi Notake Keiichi Akahoshi Hideki Takami So Yamaki Daisuke Hashimoto Yasutoshi Kimura Satoshi Hirano Yosuke Inoue Tsutomu Fujii Michiaki Unno Yasuhiro Kodera Joji Kitayama Sohei Satoi the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination |
| author_sort | Tomohisa Yamamoto |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-a6116b51d3294eeca64f175df812d3f9 |
| institution | Matheson Library |
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| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
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| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-a6116b51d3294eeca64f175df812d3f92025-07-01T14:20:07ZengWileyAnnals of Gastroenterological Surgery2475-03282025-07-019483084110.1002/ags3.70001Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective studyTomohisa Yamamoto0Toshio Shimokawa1Masamichi Hayashi2Masamichi Mizuma3Katsuhisa Hirano4Atsushi Oba5Toshimichi Asano6Hideyo Miyato7Makoto Yoshida8Ippei Matsumoto9Yasunari Kawabata10Katsunori Sakamoto11Fuyuhiko Motoi12Shigeto Ishii13Yuki Homma14Hiromitsu Maehira15Yutaro Matsunaga16Tetsuya Ikemoto17Masafumi Nakamura18Yuko Mataki19Tsuyoshi Notake20Keiichi Akahoshi21Hideki Takami22So Yamaki23Daisuke Hashimoto24Yasutoshi Kimura25Satoshi Hirano26Yosuke Inoue27Tsutomu Fujii28Michiaki Unno29Yasuhiro Kodera30Joji Kitayama31Sohei Satoi32the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal DisseminationDepartment of Pancreatobiliary Surgery Kansai Medical University Osaka JapanClinical Study Support Center, Wakayama Medical University School of Medicine Wakayama JapanDepartment of Gastroenterological Surgery Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly University of Toyama Toyama JapanDivision of Hepatobiliary and Pancreatic Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University Sapporo JapanDepartment of Gastrointestinal Surgery Jichi Medical University Shimotsuke JapanDepartment of Medical Oncology Sapporo Medical University School of Medicine Sapporo JapanDepartment of Surgery Kindai University Faculty of Medicine Osaka JapanDepartment of Digestive and General Surgery Shimane University Faculty of Medicine Izumo JapanDepartment of Hepato‐Biliary‐Pancreatic and Breast Surgery Ehime University Graduate School of Medicine Ehime JapanDepartment of Surgery Yamagata University Graduate School of Medical Science Yamagata JapanDepartment of Gastroenterology, Graduate School of Medicine Juntendo University Tokyo JapanDepartment of Gastroenterological Surgery Yokohama City University Graduate School of Medicine Yokohama JapanDepartment of Surgery Shiga University of Medical Science Otsu JapanDepartment of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo JapanDepartment of Surgery Tokushima University Tokushima JapanDepartment of Surgery and Oncology, Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Digestive Surgery, Graduate School of Medicine Kagoshima University Kagoshima JapanDivision of Gastroenterological, Hepato‐Biliary‐Pancreatic, Transplantation, and Pediatric Surgery, Department of Surgery Shinshu University School of Medicine Nagano JapanDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine Tokyo Medical and Dental University Tokyo JapanDepartment of Gastroenterological Surgery Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Pancreatobiliary Surgery Kansai Medical University Osaka JapanDepartment of Pancreatobiliary Surgery Kansai Medical University Osaka JapanDepartment of Surgery, Surgical Oncology and Science Sapporo Medical University School of Medicine Sapporo JapanDepartment of Gastroenterological Surgery II, Faculty of Medicine Hokkaido University Sapporo JapanDivision of Hepatobiliary and Pancreatic Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly University of Toyama Toyama JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Gastroenterological Surgery Nagoya University Graduate School of Medicine Nagoya JapanDepartment of Gastrointestinal Surgery Jichi Medical University Shimotsuke JapanDepartment of Pancreatobiliary Surgery Kansai Medical University Osaka JapanAbstract 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.https://doi.org/10.1002/ags3.70001intraperitoneal chemotherapyperitoneal dissemination |
| spellingShingle | Tomohisa Yamamoto Toshio Shimokawa Masamichi Hayashi Masamichi Mizuma Katsuhisa Hirano Atsushi Oba Toshimichi Asano Hideyo Miyato Makoto Yoshida Ippei Matsumoto Yasunari Kawabata Katsunori Sakamoto Fuyuhiko Motoi Shigeto Ishii Yuki Homma Hiromitsu Maehira Yutaro Matsunaga Tetsuya Ikemoto Masafumi Nakamura Yuko Mataki Tsuyoshi Notake Keiichi Akahoshi Hideki Takami So Yamaki Daisuke Hashimoto Yasutoshi Kimura Satoshi Hirano Yosuke Inoue Tsutomu Fujii Michiaki Unno Yasuhiro Kodera Joji Kitayama Sohei Satoi the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study Annals of Gastroenterological Surgery intraperitoneal chemotherapy peritoneal dissemination |
| title | Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study |
| title_full | Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study |
| title_fullStr | Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study |
| title_full_unstemmed | Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study |
| title_short | Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study |
| title_sort | clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination a multicenter retrospective study |
| topic | intraperitoneal chemotherapy peritoneal dissemination |
| url | https://doi.org/10.1002/ags3.70001 |
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