The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study


Por: Rangelova E, Stoop TF, van Ramshorst TME, Ali M, van Bodegraven EA, Javed AA, Hashimoto D, Steyerberg E, Banerjee A, Jain A, Sauvanet A, Serrablo A, Giani A, Giardino A, Zerbi A, Arshad A, Wijma AG, Coratti A, Zironda A, Socratous A, Rojas A, Halimi A, Ejaz A, Oba A, Patel BY, Björnsson B, Reames BN, Tingstedt B, Goh BKP, Payá-Llorente C, Del Pozo CD, González-Abós C, Medin C, van Eijck CHJ, de Ponthaud C, Takishita C, Schwabl C, Månsson C, Ricci C, Thiels CA, Douchi D, Hughes DL, Kilburn D, Flanking D, Kleive D, Silva DS, Edil BH, Pando E, Moltzer E, Kauffman EF, Warren E, Bozkurt E, Sparrelid E, Thoma E, Verkolf E, Ausania F, Giannone F, Hüttner FJ, Burdio F, Souche FR, Berrevoet F, Daams F, Motoi F, Saliba G, Kazemier G, Roeyen G, Nappo G, Butturini G, Ferrari G, Kito Fusai G, Honda G, Sergeant G, Karteszi H, Takami H, Suto H, Matsumoto I, Mora-Oliver I, Frigerio I, Fabre JM, Chen J, Sham JG, Davide J, Urdzik J, de Martino J, Nielsen K, Okano K, Kamei K, Okada K, Tanaka K, Labori KJ, Goodsell KE, Alberici L, Webber L, Kirkov L, de Franco L, Miyashita M, Maglione M, Gramellini M, Ramera M, Amaral MJ, Ramaekers M, Truty MJ, van Dam MA, Stommel MWJ, Petrikowski M, Imamura M, Hayashi M, D'Hondt M, Brunner M, Hogg ME, Zhang C, Suárez-Muñoz MÁ, Luyer MD, Unno M, Mizuma M, Janot M, Sahakyan MA, Jamieson NB, Busch OR, Bilge O, Belyaev O, Franklin O, Sánchez-Velázquez P, Pessaux P, Holka PS, Ghorbani P, Casadei R, Sartoris R, Schulick RD, Grützmann R, Sutcliffe R, Mata R, Patel RB, Takahashi R, Rodriguez Franco S, Cabús SS, Hirano S, Gaujoux S, Festen S, Kozono S, Maithel SK, Chai SM, Yamaki S, van Laarhoven S, Mieog JSD, Murakami T, Codjia T, Sumiyoshi T, Karsten TM, Nakamura T, Sugawara T, Boggi U, Hartman V, de Meijer VE, Bartholomä W, Kwon W, Koh YX, Cho Y, Takeyama Y, Inoue Y, Nagakawa Y, Kawamoto Y, Ome Y, Soonawalla Z, Uemura K, Wolfgang CL, Jang JY, Padbury R, Satoi S, Messersmith W, Wilmink JW, Abu Hilal M, Besselink MG, Del Chiaro M

Publicada: 1 may 2025 Ahead of Print: 1 abr 2025
Resumen:
Background: Left-sided pancreatic cancer is associated with worse overall survival (OS) compared with right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with resectable pancreatic cancer (RPC), current randomized trials included mostly patients with right-sided RPC. The purpose of this study was to assess the association between neoadjuvant therapy and OS in patients with left-sided RPC compared with upfront surgery. Patients and methods: This was an international multicenter retrospective study including consecutive patients after left-sided pancreatic resection for pathology-proven RPC, either after neoadjuvant therapy or upfront surgery in 76 centers from 18 countries on 4 continents (2013-2019). The primary endpoint was OS from diagnosis. Time-dependent Cox regression analysis was carried out to investigate the association of neoadjuvant therapy with OS, adjusting for confounders at the time of diagnosis. Adjusted OS probabilities were calculated. Results: Overall, 2282 patients after left-sided pancreatic resection for RPC were included of whom 290 patients (13%) received neoadjuvant therapy. The most common neoadjuvant regimens were (m)FOLFIRINOX (38%) and gemcitabine-nab-paclitaxel (22%). After upfront surgery, 72% of patients received adjuvant chemotherapy, mostly a single-agent regimen (74%). Neoadjuvant therapy was associated with prolonged OS compared with upfront surgery (adjusted hazard ratio 0.69, 95% confidence interval 0.58-0.83) with an adjusted median OS of 53 versus 37 months (P = 0.0003) and adjusted 5-year OS rates of 47% versus 35% (P = 0.0001) compared with upfront surgery. Interaction analysis demonstrated a stronger effect of neoadjuvant therapy in patients with a larger tumor (P-interaction = 0.003) and higher serum carbohydrate antigen 19-9 (CA19-9; P-interaction = 0.005). In contrast, the effect of neoadjuvant therapy was not enhanced for splenic artery (P-interaction = 0.43), splenic vein (P-interaction = 0.30), retroperitoneal (P-interaction = 0.84), and multivisceral (P-interaction = 0.96) involvement. Conclusions: Neoadjuvant therapy in patients with left-sided RPC was associated with improved OS compared with upfront surgery. The impact of neoadjuvant therapy increased with larger tumor size and higher serum CA19-9 at diagnosis. Randomized controlled trials on neoadjuvant therapy specifically in patients with left-sided RPC are needed.

Filiaciones:
Rangelova E:
 Department of Upper Abdominal Surgery at Sahlgrenska University Hospital, Gothenburg, Sweden

 Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

Stoop TF:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

van Ramshorst TME:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Department of Surgery, Fondazione Poliambulanza, Instituto Ospedaliero, Brescia, Italy

Ali M:
 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Amsterdam UMC, Location Vrije Universiteit, Department of Surgery, Amsterdam, The Netherlands

van Bodegraven EA:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

Javed AA:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Department of Surgical Oncology, Department of Surgery, New York University Medical Center, New York, USA

Hashimoto D:
 Department of Surgery, Kansai Medical University, Osaka, Japan

Steyerberg E:
 Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands

Banerjee A:
 HPB & Liver Transplant Unit, Royal Free Hospital, London, UK

Jain A:
 Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA

Sauvanet A:
 Department of HPB Surgery and Liver Transplantation, APHP Beaujon Hospital, University of Paris Cité, Clichy, France

Serrablo A:
 HPB Surgical Division, Miguel Servet University Hospital, Zaragoza, Spain

Giani A:
 Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Giardino A:
 Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Peschiera, Italy

Zerbi A:
 Humanitas University, Department of Biomedical Sciences, Milan, Italy

 Pancreatic Surgery Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy

Arshad A:
 Hepatopancreatobiliary Unit, University Hospitals Southampton NHS Trust, Southampton General Hospital, Southampton, UK

Wijma AG:
 Department of Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands

Coratti A:
 General and Emergency Surgery Unit, Misericordia Hospital, Azienda USL Toscana Sud-Est, Grosseto, Italy

Zironda A:
 Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, USA

Socratous A:
 Department of Upper Abdominal Surgery at Sahlgrenska University Hospital, Gothenburg, Sweden

 Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

Rojas A:
 Department of Surgery, NorthShore University Health System, Evanston, USA

Halimi A:
 Department of Surgery, Umeå University, Umeå, Sweden

 Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Ejaz A:
 Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, USA

Oba A:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

 Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo

 Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan

Patel BY:
 Hepatopancreatobiliary Unit, University Hospitals Southampton NHS Trust, Southampton General Hospital, Southampton, UK

Björnsson B:
 Department of Surgery, Linköping University Hospital, Linköping, Sweden

Reames BN:
 Department of Surgery, University of Nebraska Medical Center, Omaha, USA

Tingstedt B:
 Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital, Lund, Sweden

Goh BKP:
 Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore

Payá-Llorente C:
 General and Digestive Surgery, Hospital Doctor Peset, Valencia, Spain

Del Pozo CD:
 General and Digestive Surgery, Hospital Doctor Peset, Valencia, Spain

González-Abós C:
 Hepatobiliopancreatic Department, Hospital Clinic de Barcelona, Barcelona, Spain

Medin C:
 Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, USA

van Eijck CHJ:
 Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

de Ponthaud C:
 Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France

Takishita C:
 Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

Schwabl C:
 Department of Radiology, Medical University Innsbruck, Innsbruck, Austria

Månsson C:
 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

Ricci C:
 Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy

 Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy

Thiels CA:
 Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, USA

Douchi D:
 Department of Surgery, Tohoku University, Sendai, Japan

Hughes DL:
 Department of Hepatobiliary and Pancreatic Surgery, Oxford Radcliffe Hospitals NHS Foundation Trust, Oxford, UK

Kilburn D:
 Department of Surgery, Flinders Medical Centre, Adelaide, Australia

Flanking D:
 Department of Upper Abdominal Surgery at Sahlgrenska University Hospital, Gothenburg, Sweden

Kleive D:
 Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway

Silva DS:
 HEBIPA Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal

Edil BH:
 Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA

Pando E:
 Universitat Autònoma de Barcelona, Barcelona, Spain

 Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain

Moltzer E:
 Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

Kauffman EF:
 Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

Warren E:
 Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, USA

Bozkurt E:
 Department of General Surgery, Koç University School of Medicine, Istanbul, Turkey

Sparrelid E:
 Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Thoma E:
 Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany

Verkolf E:
 Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

Ausania F:
 Hepatobiliopancreatic Department, Hospital Clinic de Barcelona, Barcelona, Spain

 Instituto de Investigaciones Biomédicas August Pi I Sunyer (IDIBAPS), Barcelona, Spain

Giannone F:
 Department of Visceral and Digestive Surgery, University Hospital of Strasbourg, Strasbourg, France

Hüttner FJ:
 Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany

Burdio F:
 Department of Surgery, Hepatobiliary and Pancreatic Unit, Hospital del Mar de Barcelona, Barcelona, Spain

 Hospital del Mar Research Institute (IMIM), University Pompeu-Fabra, Barcelona, Spain

Souche FR:
 Oncologic & Minimally-Invasive Digestive Surgery, CHU Montpellier, University of Montpellier, Montpellier, France

Berrevoet F:
 Department of General and HPB Surgery and Liver Transplantation, Ghent University Hospital, Ghent, Belgium

Daams F:
 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Amsterdam UMC, Location Vrije Universiteit, Department of Surgery, Amsterdam, The Netherlands

Motoi F:
 Department of Surgery, Yamagata University, Yamagata, Japan

Saliba G:
 Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Kazemier G:
 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Amsterdam UMC, Location Vrije Universiteit, Department of Surgery, Amsterdam, The Netherlands

Roeyen G:
 Department of HPB, Endocrine and Transplantation Surgery, University Hospital Antwerp, Antwerp, Belgium

Nappo G:
 Humanitas University, Department of Biomedical Sciences, Milan, Italy

 Pancreatic Surgery Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy

Butturini G:
 Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Peschiera, Italy

Ferrari G:
 Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Kito Fusai G:
 HPB & Liver Transplant Unit, Royal Free Hospital, London, UK

Honda G:
 Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

Sergeant G:
 Department of Abdominal Surgery, Jessa Hospital, Faculty of Medicine and Health Sciences, Universiteit Hasselt, Hasselt, Belgium

Karteszi H:
 Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK

Takami H:
 Department of Gastroenterological Surgery (Surgery II), Nagoya University, Nagoya, Japan

Suto H:
 Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan

Matsumoto I:
 Department of Surgery, Kindai University, Osakasayama, Japan

Mora-Oliver I:
 Department of Surgery, Liver and Pancreato-Biliary Unit, Hospital Clínico Universitario Valencia, Biomedical Research Institute, INCLIVA, Valencia, Spain

Frigerio I:
 Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Peschiera, Italy

Fabre JM:
 Oncologic & Minimally-Invasive Digestive Surgery, CHU Montpellier, University of Montpellier, Montpellier, France

Chen J:
 Department of Surgery, Flinders Medical Centre, Adelaide, Australia

Sham JG:
 Department of Surgery, University of Washington, Seattle, USA

 Fred Hutchinson Cancer Center, Seattle, USA

Davide J:
 HEBIPA Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal

Urdzik J:
 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

de Martino J:
 Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France

Nielsen K:
 Department of Hepatopancreatobiliary Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

Okano K:
 Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan

Kamei K:
 Department of Surgery, Kindai University, Osakasayama, Japan

Okada K:
 Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Tanaka K:
 Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Hokkaido, Japan

Labori KJ:
 Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Goodsell KE:
 Department of Surgery, University of Washington, Seattle, USA

Alberici L:
 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

 Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy

Webber L:
 Department of Upper GI Surgery, Fiona Stanley Hospital, Perth, Austria

Kirkov L:
 Oncologic & Minimally-Invasive Digestive Surgery, CHU Montpellier, University of Montpellier, Montpellier, France

de Franco L:
 General and Emergency Surgery Unit, Misericordia Hospital, Azienda USL Toscana Sud-Est, Grosseto, Italy

Miyashita M:
 Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan

Maglione M:
 Department of Visceral, Transplant, and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria

Gramellini M:
 Humanitas University, Department of Biomedical Sciences, Milan, Italy

 Pancreatic Surgery Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy

Ramera M:
 Department of Surgery, Fondazione Poliambulanza, Instituto Ospedaliero, Brescia, Italy

 Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

Amaral MJ:
 General Surgery Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

 Faculty of Medicine, University of Coimbra, Coimbra, Portugal

Ramaekers M:
 Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands

Truty MJ:
 Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, USA

van Dam MA:
 Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

Stommel MWJ:
 Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

Petrikowski M:
 Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany

Imamura M:
 Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Hokkaido, Japan

Hayashi M:
 Department of Gastroenterological Surgery (Surgery II), Nagoya University, Nagoya, Japan

D'Hondt M:
 Department of Digestive and Hepatobiliary-Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium

Brunner M:
 Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany

Hogg ME:
 Department of Surgery, NorthShore University Health System, Evanston, USA

Zhang C:
 Department of Surgery, University of Nebraska Medical Center, Omaha, USA

Suárez-Muñoz MÁ:
 HPB Surgical Unit, University Hospital Virgen de la Victoria, Málaga, Spain

Luyer MD:
 Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands

Unno M:
 Department of Surgery, Tohoku University, Sendai, Japan

Mizuma M:
 Department of Surgery, Tohoku University, Sendai, Japan

Janot M:
 Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany

Sahakyan MA:
 The Intervention Center, Oslo University Hospital, Rigshospitalet, Oslo, Norway

Jamieson NB:
 Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, University of Glasgow, Glasgow, UK

Busch OR:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

Bilge O:
 Department of General Surgery, Koç University School of Medicine, Istanbul, Turkey

Belyaev O:
 Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany

Franklin O:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

 Department of Surgery, Umeå University, Umeå, Sweden

Sánchez-Velázquez P:
 Department of Surgery, Hepatobiliary and Pancreatic Unit, Hospital del Mar de Barcelona, Barcelona, Spain

 Hospital del Mar Research Institute (IMIM), University Pompeu-Fabra, Barcelona, Spain

Pessaux P:
 Department of Visceral and Digestive Surgery, University Hospital of Strasbourg, Strasbourg, France

Holka PS:
 Department of Clinical Sciences Lund, Surgery, Lund University, Skåne University Hospital, Lund, Sweden

Ghorbani P:
 Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Casadei R:
 Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy

 Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy

Sartoris R:
 Department of Radiology, APHP Beaujon Hospital, University of Paris Cité, Clichy, France

Schulick RD:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

Grützmann R:
 The Intervention Center, Oslo University Hospital, Rigshospitalet, Oslo, Norway

Sutcliffe R:
 Department of Hepatopancreatobiliary Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

Mata R:
 Universitat Autònoma de Barcelona, Barcelona, Spain

 Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain

Patel RB:
 Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, USA

Takahashi R:
 Department of Surgery, Yamagata University, Yamagata, Japan

Rodriguez Franco S:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

Cabús SS:
 Department of HPB Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Hirano S:
 Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Hokkaido, Japan

Gaujoux S:
 Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France

Festen S:
 Department of Surgery, OLVG, Amsterdam, The Netherlands

Kozono S:
 Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

Maithel SK:
 Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, USA

Chai SM:
 Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth, Australia

Yamaki S:
 Department of Surgery, Kansai Medical University, Osaka, Japan

van Laarhoven S:
 Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

 Department of HPB Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK

Mieog JSD:
 Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

Murakami T:
 Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Hokkaido, Japan

Codjia T:
 Department of Digestive Surgery, Rouen University Hospital, Rouen, France

Sumiyoshi T:
 Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Karsten TM:
 Department of Surgery, OLVG, Amsterdam, The Netherlands

Nakamura T:
 Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Hokkaido, Japan

Sugawara T:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

 Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo

Boggi U:
 Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

Hartman V:
 Department of HPB, Endocrine and Transplantation Surgery, University Hospital Antwerp, Antwerp, Belgium

de Meijer VE:
 Department of Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands

Bartholomä W:
 Department of Radiology, Linköping University, Linköping, Sweden

Kwon W:
 Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

Koh YX:
 Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore

Cho Y:
 Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

Takeyama Y:
 Department of Surgery, Kindai University, Osakasayama, Japan

Inoue Y:
 Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan

Nagakawa Y:
 Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

Kawamoto Y:
 Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

Ome Y:
 Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

Soonawalla Z:
 Department of Hepatobiliary and Pancreatic Surgery, Oxford Radcliffe Hospitals NHS Foundation Trust, Oxford, UK

Uemura K:
 Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Wolfgang CL:
 Department of Surgical Oncology, Department of Surgery, New York University Medical Center, New York, USA

Jang JY:
 Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

Padbury R:
 Department of Surgery, Flinders Medical Centre, Adelaide, Australia

Satoi S:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

 Department of Surgery, Kansai Medical University, Osaka, Japan

Messersmith W:
 Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, USA

Wilmink JW:
 Cancer Center Amsterdam, Amsterdam, the Netherlands

 Amsterdam UMC, Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands

Abu Hilal M:
 Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Peschiera, Italy

Besselink MG:
 Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands

 Cancer Center Amsterdam, Amsterdam, the Netherlands

Del Chiaro M:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

Michalski CW:
 Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany

de Wilde RF:
 Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

Tufekci T:
 Department of General Surgery, Koç University School of Medicine, Istanbul, Turkey

Ishida H:
 Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, USA

 Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Dennahy IS:
 Division of Surgical Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA

Carter JA:
 Department of Surgery, University of Washington, Seattle, Japan

Olapo JS:
 Department of Surgery, University of Washington, Seattle, Japan

Caldera M:
 Hepatobiliopancreatic Department, Hospital Clinic de Barcelona, Barcelona, Spain

Mazzola M:
 Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, USA

Oshima M:
 Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan

Tanaka N:
 Department of Gastroenterological Surgery (Surgery II), Nagoya University, Nagoya, Japan

Choi SH:
 Department of Surgery, NorthShore University Health System, Evanston, USA

Sato S:
 Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan

Sugawara S:
 Department of Surgery, Yamagata University, Yamagata, Japan

Abadia-Forcen T:
 HPB Surgical Division, Miguel Servet University Hospital, Zaragoza, Spain

Pawlik TM:
 Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, USA

Kimura Y:
 Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Hokkaido, Japan
ISSN: 09237534





ANNALS OF ONCOLOGY
Editorial
OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 36 Número: 5
Páginas: 529-542
WOS Id: 001498312500001
ID de PubMed: 39814200
imagen Green Submitted, hybrid

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imagen Published Version CC BY-NC-ND 4.0

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