TF Stoop

It’s out!!! 🔥🔥🔥 The PREOPANC-2 is in @thelancet.com

Neoadjuvant FOLFIRINOX 🤜🤛 Gemcitabine based chemoradiotherapy in resecatble / BR

⚖️ No difference in overall survival
😰 Serious adverse events 40%

👍 Both regimens may be considered

www.thelancet.com/pdfs/journal...

Resectability stages of pancreatic cancer: nationwide reference At diagnosis, pancreatic adenocarcinoma is categorized into resectability stages based on extent of vascular involvement and presence of metastases at cros

This population-based study on the NCCN resectability stages of pancreatic adenocarcinoma indicates that the rate of LAPC was lower than reported in literature, whereas the rate of PRPC is higher

Published in @bjsurgery.bsky.social, unique nationwide 🇳🇱 data @dpcgofficial.bsky.social on #NCCN resectability staging of #PancreaticCancer at diagnosis:
🧷 23% PRPC
🧷 8% BRPC
🧷 11% LAPC
🧷 58% M1
… including stratification for tumour location.

👉 academic.oup.com/bjs/article/...

HPB Journal Highlight ⭐️Ishida et al. Global survey shows big variation in how surgeons manage neck of pancreas cancers, especially with vascular involvement. Highlights the need for future studies & clearer guidelines! 🔗https://tinyurl.com/3myun89t 📊🌎 #PancreaticCancer #HPBSurgery

Distribution of the NCCN stages of #PancreaticCancer ?

16,412 pts (2017-2022) 🇳🇱
👉23% primary resectable
👉 8% borderline resectable
👉 11% locally advanced
👉 58% metastatic

⏩️ academic.oup.com/bjs/article/11…

Published in #BJC, our 🌎 study with 935 localized #pancreaticancer patients after resection, comparing preoperative FFX vs GnP:

📎FFX vs GnP not associated with OS (p=0.17)
📎Effect FFX ⬆️ if lower serum CA19.9 #tumorbiology
🚨Pragmatic RCT #chemosensitivitymarkers🔍

👉 www.nature.com/articles/s41...

Immensely honored to receive a Honorary Fellowship with #ASA #American #Surgical #Association #AnnalsOfSurgery in #SanDiego

Figure showing most common symptoms and signs of pancreatic cancer at diagnosis. Copyright: Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Pancreatic cancer, often linked to smoking, obesity and diabetes, is predicted to become the 2nd leading cause of cancer-related death by 2030.

A recent Seminar discusses the need for novel therapies & future directions for research: tinyurl.com/ywue2nfs

👉 www.thelancet.com/journals/lan...

NB. Corrected version will be published next week.

Published in @thelancet.bsky.social, our review on #PancreaticCancer
📎Epidemiology🌎
📎Pathogenesis🔬
📎Risk factors & surveillance🕵️
📎Diagnostics🩺
📎Treatment💊
📎Future directions🔍
… by AA Javed, A Oba, T Seufferlein, JW Wilmink, @basgrootkoerkamp.bsky.social & @marcbesselink.bsky.social.

Congrats to #AnoukEmmen and @tfstoop.bsky.social for excellent presentations in the #PresidentialSession #AHPBA2025 AHPBA Miami 🇺🇸: #DIPLOMA2 RCT🇪🇺 robot/lap 🤖 vs open Whipple and #PREOPANC4🇳🇱 implementation of surgery for locally advanced #PancreaticCancer for @dpcgofficial.bsky.social and #EMIPS

👉 full text: www.sciencedirect.com/science/arti...

Published in #hpbjournal, 🌎 survey on surgical management of pancreatic neck/body cancer with venous involvement:

📝222 surgeons, 49 countries, 6 continents

📍Heterogeneity in surgical management➡️particularly when ⬆️ venous involvement

⚠️ Need for research 🔍

@eahpba.bsky.social @ihpba.bsky.social

In JNCCN our nationwide study on quality of life in patients with locally advanced PDAC 🇳🇱

⭐️ QoL remains stable over time, regardless of receiving treatment (89%)
😱 Symptoms significantly deteriorate and deserve attention

➡️ Use in shared decision making

@dpcgofficial.bsky.social

Nationwide implementation of the international multidisciplinary best-practice for locally advanced pancreatic cancer (PREOPANC-4): study protocol - BMC Cancer Background The introduction of (m)FOLFIRINOX and gemcitabine-nab-paclitaxel has changed the perspective for patients with locally advanced pancreatic cancer (LAPC). Consequently, in experienced centre...

👉 full text: bmccancer.biomedcentral.com/articles/10....

In #BMC Cancer, #PREOPANC4 protocol to improve #LAPC care in 🇳🇱 @dpcgofficial.bsky.social with help of 4 international experts🇩🇪🇺🇸:

📎Multidisciplinary & surgical training program
📎Structured induction therapy, response evaluation & selection for surgery
📎National expertpanel
📎Patient-centered care

Looking back at an incredible #ALPS2025 meeting and delighted to have been awarded the Best Mini-Oral Presentation for our cost-analysis of robot vs open Whipple! Many thanks to the @amsterdamumc.bsky.social HPB-team @MichielFrancken @marcbesselink.bsky.social #roboticsurgery #pancreas

Preoperative stereotactic radiotherapy to prevent pancreatic fistula in high-risk patients undergoing pancreatoduodenectomy (FIBROPANC): prospective multicentre phase II single-arm trial The FIBROPANC study investigated the safety, feasibility, and efficacy of preoperative stereotactic radiotherapy on the pancreatic neck transection margin

Preoperative stereotactic radiotherapy to prevent pancreatic fistula in high-risk patients undergoing pancreatoduodenectomy (FIBROPANC): prospective multicentre phase II single-arm trial
➡️ doi.org/10.1093/bjs/...

Can prophylactic #Radiotherapy #SBRT in non-PDAC #pancreatoduodenectomy prevent fistula POPF?

🔑 “it works but doesn’t help”

▶️#FIBROPANC published today @bjsurgery.bsky.social @dpcgofficial.bsky.social @eahpba.bsky.social @ihpba.bsky.social

academic.oup.com/bjs/article/...

Adjuvant Chemotherapy After Resection of Pancreatic Adenocarcinoma Following Preoperative FOLFIRINOX This cohort study investigates the association of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative FOLFIRINOX in full or modified dosing with overall survival,...

Full text here 👉🏼 jamanetwork.com/journals/jam...

In JAMA Oncology our 🌎 @eahpba.bsky.social study on adjuvant chemo (AT) in 742 resected localized #PDAC patients following NAT #FFX (40 centers):

📌OS ⬆️ by AT;
… only with multi-agent AT ⚠️

📌Possibly less effect of AT if >=8c NAT FFX, RECIST response, ypN0 & head tumor 📣

📯RCT🟰🔑

Tangential Versus Segmental Portomesenteric Venous... : Annals of Surgery mparative studies on tangential versus segmental PVR as part of pancreatoduodenectomy for pancreatic cancer include all degrees of PMV involvement, including cases where tangential PVR may not be a fe...

👉🏼 full text here: journals.lww.com/annalsofsurg...

PVR 1-2 vs 3-4 during pancreatoduodenectomy for resectable #PDAC with venous involvement?

In Annals of Surgery, our observational study with 357 patients from 🇸🇪🇯🇵🇳🇱🇺🇸:

📌PVR type NOT associated with OS, locoregional recurrence & major morbidity

➡️ surgeon’s personal preference

Neoadjuvant chemotherapy for left 👈 sided resectable #PDAC

🪡 72% of US received adjuvant
💉 NAT had better OS (53 🆚 37 months)

🤏 Tumor size and 🧪 elevated CA19.9 correlates with benefits of NAT

And now… time for RCT! 💪

#HPBSky

www.annalsofoncology.org/article/S092...

The impact of neoadjuvant therapy in patients with left-sided resectable pancreatic cancer: an international multicenter study To assess the association between neoadjuvant therapy and overall survival (OS) in patients with left-sided resectable pancreatic cancer (RPC) compared to upfront surgery.

www.annalsofoncology.org/article/S092...

NAT for left-sided RPC?

In Annals of Oncology our 🌎 observational study on #NAT vs #US in 2282 patients with resected left-sided #RPC (76 centers):

📌OS⬆️after NAT vs US
… 5y OS 47% vs 35%

📌NAT effect⬆️in large tumors & higher CA19.9 at diagnosis

🔑🟰ABC-approach

📯RCT

See full text below 👇

Perioperative therapy for #Pancreas Cancer

⭐️ A stellar lecture by the great Matthew H Katz 🇺🇸 @mdanderson.bsky.social ⭐️

All you need to know, and future perspectives in the eyes of a true pioneer of neoadjuvant chemo #HPBSky #SurgSky #MedSky

youtube.com/watch?v=kIlH...

2025 Multi-Societal #European #Guideline on #PancreaticCancer

✅ Meeting with our 39 amazing Research leads to discuss group progress and any issues

▶️ 30 Societies
▶️ 13 Working groups
▶️ Focus on knowledge gaps

@eahpba.bsky.social Laura Leeuwenburgh, Magdalena Holze, Elena Rangelova

Surgical management of severe pancreatic fistula after pancreatoduodenectomy: a comparison of early versus late rescue pancreatectomy - Langenbeck's Archives of Surgery Background Rescue pancreatectomy for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) is associated with high mortality. However, in-depth literature is scarce and hard to inte...

Hypothesizing paper @karolinskainst.bsky.social on POPF grade C management including early vs late rescue pancreatectomy:

link.springer.com/article/10.1...

Challenging #patientselection ⚖️ step-up approach PORSCH trial #DPCG