TY - JOUR
T1 - Validation of the PANAMA-Score for Survival and Benefit of Adjuvant Therapy in Patients with Resected Pancreatic Cancer After Neoadjuvant FOLFIRINOX
AU - Rompen, Ingmar F.
AU - Stoop, Thomas F.
AU - Van Roessel, Stijn
AU - Van Veldhuisen, Eran
AU - Janssen, Quisette P.
AU - Alseidi, Adnan
AU - Balduzzi, Alberto
AU - Balzano, Gianpaolo
AU - Berrevoet, Frederik
AU - Bonds, Morgan
AU - Busch, Olivier R.
AU - Butturini, Giovanni
AU - Javed, Ammar A.
AU - Del Chiaro, Marco
AU - Conlon, Kevin C.
AU - Falconi, Massimo
AU - Frigerio, Isabella
AU - Fusai, Giuseppe K.
AU - Gagnière, Johan
AU - Griffin, Oonagh
AU - Hackert, Thilo
AU - Sparrelid, Ernesto
AU - Halimi, Asif
AU - Labori, Knut J.
AU - Malleo, Giuseppe
AU - Marino, Marco V.
AU - Mortensen, Michael B.
AU - Nikov, Andrej
AU - Lesurtel, Mickaël
AU - Keck, Tobias
AU - Kleeff, Jörg
AU - Pandé, Rupaly
AU - Pfeiffer, Per
AU - Pietrasz, Daniel
AU - Roberts, Keith J.
AU - Sa Cunha, Antonio
AU - Salvia, Roberto
AU - Strobel, Oliver
AU - Tarvainen, Timo
AU - Van Laarhoven, Hanneke W.M.
AU - Koerkamp, Bas Groot
AU - Loos, Martin
AU - Michalski, Christoph
AU - Besselink, Marc G.
AU - Hank, Thomas
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/1/31
Y1 - 2025/1/31
N2 - Aim: To validate the prognostic value of the PAncreatic NeoAdjuvant MAssachusetts (PANAMA)-score and to determine its predictive ability for survival benefit derived from adjuvant treatment in patients after resection of pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant FOLFIRINOX Background: The PANAMA-score was developed to guide prognostication in patients after neoadjuvant therapy and resection for PDAC. As this score focuses on the risk for residual disease after resection, it might also be able to select patients who benefit from adjuvant after neoadjuvant therapy. Methods: This retrospective international multicenter study is endorsed by the European-African Hepato-Pancreato-Biliary Association (E-AHPBA). Patients with PDAC who underwent resection after neoadjuvant FOLFIRINOX were included. Mantel-Cox regression with interaction analysis was performed to assess the impact of adjuvant chemotherapy.Results: Overall, 383 patients after resection of PDAC following neoadjuvant FOLFIRINOX were included of whom 187 (49%), 137 (36%), and 59 (15%) had a low-risk, intermediate-risk, and high-risk PANAMA-score, respectively. A discrimination in median OS was observed stratified by risk groups (48.5, 27.6, and 22.3 months, Log-Rank-Plow-intermediate=0.004, Log-Rank-Pintermediate-high=0.027). Adjuvant therapy was not associated with an OS difference in the low-risk group (HR 1.50, 95%CI:0.92-2.50), whereas improved OS was observed in the intermediate (HR 0.58, 95%CI:0.34-0.97) and high-risk groups (HR 0.47, 95%CI:0.24-0.94) (p-interaction=0.008). Conclusions: The PANAMA 3-tier risk groups (low-risk, intermediate-risk, and high-risk, available via pancreascalculator.com) correspond with differential survival in patients with resected PDAC following neoadjuvant FOLFIRINOX. The risk groups also differentiate between survival benefit associated with adjuvant treatment, with only the intermediate- and high-risk groups associated with improved OS.
AB - Aim: To validate the prognostic value of the PAncreatic NeoAdjuvant MAssachusetts (PANAMA)-score and to determine its predictive ability for survival benefit derived from adjuvant treatment in patients after resection of pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant FOLFIRINOX Background: The PANAMA-score was developed to guide prognostication in patients after neoadjuvant therapy and resection for PDAC. As this score focuses on the risk for residual disease after resection, it might also be able to select patients who benefit from adjuvant after neoadjuvant therapy. Methods: This retrospective international multicenter study is endorsed by the European-African Hepato-Pancreato-Biliary Association (E-AHPBA). Patients with PDAC who underwent resection after neoadjuvant FOLFIRINOX were included. Mantel-Cox regression with interaction analysis was performed to assess the impact of adjuvant chemotherapy.Results: Overall, 383 patients after resection of PDAC following neoadjuvant FOLFIRINOX were included of whom 187 (49%), 137 (36%), and 59 (15%) had a low-risk, intermediate-risk, and high-risk PANAMA-score, respectively. A discrimination in median OS was observed stratified by risk groups (48.5, 27.6, and 22.3 months, Log-Rank-Plow-intermediate=0.004, Log-Rank-Pintermediate-high=0.027). Adjuvant therapy was not associated with an OS difference in the low-risk group (HR 1.50, 95%CI:0.92-2.50), whereas improved OS was observed in the intermediate (HR 0.58, 95%CI:0.34-0.97) and high-risk groups (HR 0.47, 95%CI:0.24-0.94) (p-interaction=0.008). Conclusions: The PANAMA 3-tier risk groups (low-risk, intermediate-risk, and high-risk, available via pancreascalculator.com) correspond with differential survival in patients with resected PDAC following neoadjuvant FOLFIRINOX. The risk groups also differentiate between survival benefit associated with adjuvant treatment, with only the intermediate- and high-risk groups associated with improved OS.
UR - http://www.scopus.com/inward/record.url?scp=85217787603&partnerID=8YFLogxK
U2 - 10.1097/sla.0000000000006650
DO - 10.1097/sla.0000000000006650
M3 - Article
C2 - 39886770
AN - SCOPUS:85217787603
SN - 0003-4932
VL - 281
SP - 852
EP - 860
JO - Annals of Surgery
JF - Annals of Surgery
IS - 5
M1 - 6650
ER -
