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Pancreatoduodenectomy following neoadjuvant chemoradiation therapy in uncinate process pancreatic cancer.

Title
 Pancreatoduodenectomy following neoadjuvant chemoradiation therapy in uncinate process pancreatic cancer. 
Authors
 Kang, Chang Moo ; Choi, Jin-Young ; Chung, Jae Bock ; Kim, Myung-Jin ; Lee, Woo Jung ; Song, Si Young ; Seong, Jin Sil 
Issue Date
2012
Journal Title
 Pancreas 
ISSN
 0885-3177 
Citation
 Pancreas, Vol.41(3) : 467~473, 2012 
Abstract
OBJECTIVE: The objective of the study was to delineate surgical outcomes of pancreatoduodenectomy following neoadjuvant concurrent chemoradiation therapy (CCRT) in uncinate process pancreatic cancer (UPC). METHODS: We reviewed 97 patients with resected usual pancreatic head cancer (PHC) and UPC and analyzed clinicopathologic characteristics and survival outcomes of PHC and UPC with a review of the reported literature regarding UPC. RESULTS: Twenty-five patients (27.8%) had UPC, and 72 patients had PHC. Pylorus-preserving pancreatoduodenectomy was performed in 67 patients (69.1%) and conventional pancreatoduodenectomy in 28 patients (28.9%), and 2 patients needed total pancreatectomies. When comparing UPCs with PHCs, less frequent jaundice (P = 0.009) and more advanced stages of cancers at the time of diagnosis (linear-to-linear association, P = 0.03) were found in UPCs, and CCRT was administered more frequently in UPCs (P = 0.013). Survival outcomes between PHC and UPC were similar, with median survival rates of 25.9 and 30.5 months, respectively (P = 0.702). In addition, disease-free survival was similar between the 2 groups (15.6 and 15.2 months, respectively; P = 0.4503). Our oncologic outcome of pancreatectomy for UPC is likely to be more acceptable compared with those previously reported in the literature. CONCLUSIONS: Although UPCs are found in relatively advanced clinical stages, favorable oncologic outcomes may be obtained by pancreatectomy following preoperative CCRT.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/91628
DOI
10.1097/MPA.0b013e31822a68bc
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Surgery
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
1. 연구논문 > 1. College of Medicine > Dept. of Radiation Oncology
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 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006676-201204000-00017&LSLINK=80&D=ovft
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