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Effects of neoadjuvant combined chemotherapy and radiation therapy on the CT evaluation of resectability and staging in patients with pancreatic head cancer

 Yeo-Eun Kim  ;  Mi-Suk Park  ;  Hye-Suk Hong  ;  Chang Moo Kang  ;  Jin-Young Choi  ;  Joon Seok Lim  ;  Woo Jung Lee  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
 RADIOLOGY, Vol.250(3) : 758-765, 2009 
Journal Title
Issue Date
Adult ; Aged ; Chemotherapy, Adjuvant/methods* ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Pancreatectomy/methods* ; Pancreatic Neoplasms/diagnosis* ; Pancreatic Neoplasms/therapy* ; Patient Selection ; Prognosis ; Radiotherapy, Adjuvant/methods* ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods* ; Treatment Outcome
PURPOSE: To evaluate the effect of neoadjuvant combined chemotherapy and radiation therapy (CCRT) on preoperative accuracy of multidetector computed tomography (CT) for resectability and tumor staging in patients with pancreatic head cancer.

MATERIALS AND METHODS: This retrospective study received institutional review board approval and was exempted from informed consent requirements. From May 2002 to March 2007, 38 patients with pancreatic head adenocarcinoma underwent multidetector CT before surgery. Of these, 12 patients received neoadjuvant CCRT. Imaging findings were evaluated for tumor resectability and tumor staging. Surgical and pathologic results were used as the reference standard. The accuracy of resectability and individual components of each T category were compared between the patients with neoadjuvant CCRT and without it by using the chi(2) test or Fisher exact test. A P of less than .05 was considered as significant.

RESULTS: The accuracy in determining resectability was 83% (10 of 12) in patients who had received neoadjuvant CCRT and 81% (21 of 26) in patients who had not, without significant difference (P > .05). Of 32 patients who underwent pancreaticoduodenectomy, histopathologic tumor staging was reported for T1 (n = 2), T2 (n = 1), and T3 (n = 9) lesions in patents with neoadjuvant CCRT (n = 12), and for T3 in all patients without neoadjuvant CCRT (n = 20). T-staging accuracy was 67% (eight of 12) with neoadjuvant CCRT and 95% (19 of 20) without it, with a significant difference (P = .0185).

CONCLUSION: Neoadjuvant CCRT reduces the accuracy of tumor restaging after treatment of pancreatic head cancer, but this effect is not so great as to affect the determination of resectability
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Yeo Eun(김여은)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
Hong, Hye Suk(홍혜숙) ORCID logo https://orcid.org/0000-0001-7398-2517
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