{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:03:49Z","timestamp":1790420629873,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Onno Ruding Foundation"},{"name":"Hendrik Muller Foundation"},{"name":"Crone-Haver Droeze Foundation"},{"name":"Fulbright Foundation"},{"DOI":"10.13039\/501100001826","name":"Dutch Cancer Society","doi-asserted-by":"publisher","award":["13417"],"award-info":[{"award-number":["13417"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"Dutch Cancer Society","doi-asserted-by":"publisher","award":["10140022010009"],"award-info":[{"award-number":["10140022010009"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Restaging after neoadjuvant chemotherapy aims to assess treatment response, revise prognosis, and guide further management. This study investigated independent prognostic factors for overall survival after restaging in patients with localized pancreatic adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective international study, consecutive patients with localized pancreatic adenocarcinoma who received at least 1 cycle of (m)FOLFIRINOX as first-line therapy were identified. Multivariable Cox regression analysis was performed with a web-based calculator to predict individualized overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Trans-Atlantic Pancreatic Surgery cohort included 2338 patients with localized pancreatic adenocarcinoma of whom 22.6% were potentially resectable, 30.7% borderline resectable, and 46.7% locally advanced at initial staging. Several baseline characteristics remained independent prognostic factors for overall survival after restaging: borderline resectable (hazard ratio [HR] = 1.31, 95% confidence interval [CI] = 1.14 to 1.51), locally advanced (HR = 1.78, 95% CI = 1.55 to 2.05), body or tail tumor (HR = 0.79, 95% CI = 0.68 to 0.90), and baseline World Health Organization performance status of 1 (HR = 1.18, 95% CI = 1.07 to 1.30) or at least 2 (HR = 1.54, 95% CI = 1.20 to 1.98). Additional independent factors were metastatic disease at restaging (HR = 1.57, 95% CI = 1.31 to 1.87), postinduction carbohydrate antigen 19-9 (HR = 1.47, 95% CI = 1.37 to 1.57), \u0394carbohydrate antigen 19-9 (HR = 0.83, 95% CI = 0.77 to 0.89), postinduction tumor size (HR = 1.22, 95% CI = 1.11 to 1.35), and \u0394tumor size (HR = 0.92, 95% CI = 0.87 to 0.98). Patients were stratified into 4 risk groups, with 3-year overall survival after restaging ranging from 6.0% to 65.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Survival at restaging after neoadjuvant chemotherapy of patients with localized pancreatic adenocarcinoma is determined by 8 patient, tumor, and treatment response characteristics. A web-based calculator can inform clinicians and patients about individualized prognosis and guide further management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag024","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:55:30Z","timestamp":1773996930000},"page":"1108-1114","source":"Crossref","is-referenced-by-count":1,"title":["Restaging after neoadjuvant FOLFIRINOX for localized pancreatic cancer: a clinical calculator from the Trans-Atlantic Pancreatic Surgery consortium"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3040-6736","authenticated-orcid":false,"given":"Esther N","family":"Dekker","sequence":"first","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-606X","authenticated-orcid":false,"given":"David","family":"van Klaveren","sequence":"additional","affiliation":[{"name":"Department of Public Health, Center for Medical Decision Making, Erasmus MC , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1294-0090","authenticated-orcid":false,"given":"Eva M M","family":"Verkolf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roeland F","family":"de Wilde","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2650-9350","authenticated-orcid":false,"given":"Marc G","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]},{"name":"Cancer Center Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen M","family":"O\u2019Reilly","sequence":"additional","affiliation":[{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-1711","authenticated-orcid":false,"given":"Alessandro","family":"Paniccia","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, University of Pittsburgh Medical Center , Pittsburgh, PA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2505-959X","authenticated-orcid":false,"given":"Alice C","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-5464","authenticated-orcid":false,"given":"Amer H","family":"Zureikat","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, University of Pittsburgh Medical Center , Pittsburgh, PA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-2361","authenticated-orcid":false,"given":"Laura R","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center , Houston, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3870-6968","authenticated-orcid":false,"given":"Matthew H G","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center , Houston, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6035-7288","authenticated-orcid":false,"given":"Ching-Wei D","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center , Houston, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6973","authenticated-orcid":false,"given":"Bas","family":"Groot Koerkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Trans-Atlantic Pancreatic Surgery Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew H G","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Wei D","family":"Tzeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas Groot","family":"Koerkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Paniccia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice C","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer H","family":"Zureikat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G","family":"Besselink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther N","family":"Dekker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva M M","family":"Verkolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R","family":"Prakash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"2026060902504292300_djag024-B1","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.1158\/0008-5472.CAN-14-0155","article-title":"Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States","volume":"74","author":"Rahib","year":"2014","journal-title":"Cancer Res"},{"key":"2026060902504292300_djag024-B2","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1038\/s41571-019-0253-x","article-title":"Global Consultation on Cancer Staging: promoting consistent understanding and use","volume":"16","author":"Brierley","year":"2019","journal-title":"Nat Rev Clin Oncol"},{"key":"2026060902504292300_djag024-B3","first-page":"3","article-title":"Principles of cancer staging","volume":"8","author":"Gress","year":"2017","journal-title":"AJCC Cancer Staging Manual"},{"key":"2026060902504292300_djag024-B4","first-page":"180","article-title":"The staging of cancer: a retrospective and prospective appraisal","volume":"58","author":"Greene","year":"2008","journal-title":"CA Cancer J Clin"},{"key":"2026060902504292300_djag024-B5","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1200\/JCO.23.01311","article-title":"Improved clinical staging system for localized pancreatic cancer using the ABC factors: a TAPS consortium study","volume":"42","author":"Dekker","year":"2024","journal-title":"J Clin Oncol"},{"key":"2026060902504292300_djag024-B6","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.jamcollsurg.2007.12.020","article-title":"Borderline resectable pancreatic cancer: the importance of this emerging stage of disease","volume":"206","author":"Katz","year":"2008","journal-title":"J Am Coll Surg"},{"key":"2026060902504292300_djag024-B7","author":"Network TNCC","year":"2024"},{"key":"2026060902504292300_djag024-B8","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1038\/s41571-023-00746-1","article-title":"Neoadjuvant therapy for pancreatic cancer","volume":"20","author":"Springfeld","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"2026060902504292300_djag024-B9","first-page":"140","article-title":"Current and future cancer staging after neoadjuvant treatment for solid tumors","volume":"71","author":"Byrd","year":"2021","journal-title":"CA: A Cancer J Clin"},{"key":"2026060902504292300_djag024-B10","doi-asserted-by":"crossref","first-page":"5749","DOI":"10.1002\/cncr.27636","article-title":"Response of borderline resectable pancreatic cancer to neoadjuvant therapy is not reflected by radiographic indicators","volume":"118","author":"Katz","year":"2012","journal-title":"Cancer"},{"key":"2026060902504292300_djag024-B11","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1093\/jnci\/djac018","article-title":"FOLFIRINOX as initial treatment for localized pancreatic adenocarcinoma: a retrospective analysis by the trans-atlantic pancreatic surgery consortium","volume":"114","author":"Janssen","year":"2022","journal-title":"J Natl Cancer Inst"},{"key":"2026060902504292300_djag024-B12","doi-asserted-by":"crossref","first-page":"783","DOI":"10.6004\/jnccn.2022.7008","article-title":"Neoadjuvant radiotherapy after (m)FOLFIRINOX for borderline resectable pancreatic adenocarcinoma: a TAPS consortium study","volume":"20","author":"Janssen","year":"2022","journal-title":"J Natl Compr Canc Netw"},{"key":"2026060902504292300_djag024-B13","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"147","author":"Von Elm","year":"2007","journal-title":"Ann Intern Med"},{"key":"2026060902504292300_djag024-B14","author":"Harrel","year":"2001"},{"key":"2026060902504292300_djag024-B15","author":"van Buuren","year":"2015"},{"key":"2026060902504292300_djag024-B16","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jclinepi.2015.04.005","article-title":"Prediction models need appropriate internal, internal-external, and external validation","volume":"69","author":"Steyerberg","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"2026060902504292300_djag024-B17","author":"R Core Team","year":"2021"},{"key":"2026060902504292300_djag024-B18","doi-asserted-by":"crossref","first-page":"4672","DOI":"10.3390\/cancers14194672","article-title":"Evaluation of the 8th edition AJCC staging system for the clinical staging of pancreatic cancer","volume":"14","author":"Kang","year":"2022","journal-title":"Cancers"},{"key":"2026060902504292300_djag024-B19","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.hbpd.2018.01.014","article-title":"Evaluation of the 8th AJCC staging system for pathologically versus clinically staged pancreatic adenocarcinoma: a time to revisit a dogma?","volume":"17","author":"Abdel-Rahman","year":"2018","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"2026060902504292300_djag024-B20","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/s12957-020-01951-3","article-title":"Accuracy of various criteria for lymph node staging in ductal adenocarcinoma of the pancreatic head by computed tomography and magnetic resonance imaging","volume":"18","author":"Loch","year":"2020","journal-title":"World J Surg Oncol"},{"key":"2026060902504292300_djag024-B21","doi-asserted-by":"crossref","first-page":"475","DOI":"10.2214\/ajr.180.2.1800475","article-title":"CT and pathologic assessment of prospective nodal staging in patients with ductal adenocarcinoma of the head of the pancreas","volume":"180","author":"Roche","year":"2003","journal-title":"AJR Am J Roentgenol"},{"key":"2026060902504292300_djag024-B22","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/jnci\/djae294","article-title":"Prognostic factors in localized pancreatic ductal adenocarcinoma after neoadjuvant therapy and resection: a systematic review and meta-analysis","volume":"117","author":"Javed","year":"2025","journal-title":"J Natl Cancer Inst"},{"key":"2026060902504292300_djag024-B23","first-page":"10.1097","article-title":"Implications of neoadjuvant therapy on prognostic factors in pancreatic ductal adenocarcinoma: a path towards personalized prognostication","author":"Javed","year":"2025","journal-title":"Ann Surg"},{"key":"2026060902504292300_djag024-B24","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/SLA.0000000000005184","article-title":"Prognosis associated with CA19-9 response dynamics and normalization during neoadjuvant therapy in resected pancreatic adenocarcinoma","volume":"277","author":"Newhook","year":"2023","journal-title":"Annals of Surgery"},{"key":"2026060902504292300_djag024-B25","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1245\/s10434-019-08156-3","article-title":"Serum CA19-9 response to neoadjuvant therapy predicts tumor size reduction and survival in pancreatic adenocarcinoma","volume":"27","author":"Al Abbas","year":"2020","journal-title":"Ann Surg Oncol"},{"key":"2026060902504292300_djag024-B26","author":"Mackillop","year":"2003"}],"container-title":["JNCI: Journal of the National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djag024\/67424238\/djag024.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/article-pdf\/118\/6\/1108\/67424238\/djag024.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/article-pdf\/118\/6\/1108\/67424238\/djag024.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:50:52Z","timestamp":1780987852000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnci\/article\/118\/6\/1108\/8529766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3,17]]},"published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jnci\/djag024","relation":{},"ISSN":["0027-8874","1460-2105"],"issn-type":[{"value":"0027-8874","type":"print"},{"value":"1460-2105","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,3,17]]}}}