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Potential contribution of preoperative neoadjuvant concurrent chemoradiation therapy on margin-negative resection in borderline resectable pancreatic cancer

Authors
 Chang Moo Kang  ;  Yong Eun Chung  ;  Jeong Youp Park  ;  Jin Sil Sung  ;  Ho Kyoung Hwang  ;  Hye Jin Choi  ;  Hyunki Kim  ;  Si Young Song  ;  Woo Jung Lee 
Citation
 JOURNAL OF GASTROINTESTINAL SURGERY, Vol.16(3) : 509-517, 2012 
Journal Title
 JOURNAL OF GASTROINTESTINAL SURGERY 
ISSN
 1091-255X 
Issue Date
2012
MeSH
Adenocarcinoma/pathology* ; Adenocarcinoma/therapy ; Antineoplastic Agents/therapeutic use* ; Chemoradiotherapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Pancreatectomy* ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/therapy* ; Preoperative Care/methods* ; Retrospective Studies ; Treatment Outcome
Keywords
Neoadjuvant ; Chemoradiation ; Pancreatic cancer ; Borderline resectable
Abstract
BACKGROUND: Margin-negative pancreatectomy provides only chance to cure pancreatic cancer. However, borderline resectable pancreatic cancer (BRPCa) has the risk of incomplete palliative resection. MATERIALS AND METHODS: We retrospectively reviewed 32 patients with BRPCa who underwent a pancreatectomy following preoperative chemoradiation therapy (CCRT (+)/Px group) and compared these patients with those with resectable pancreatic cancer (RPCa) who underwent pancreatectomy without preoperative CCRT (CCRT (-)/Px group, n=104). RESULTS: Eighteen patients (56.2%) showed more than 50% significant pathological response to CCRT. The degree of pathological responses showed a positive relationship between final pT stage (p=0.075). More frequent vascular resection (p<0.001), transfusion (p=0.076), and longer operation time were observed in the CCRT(+)/Px group. However, similar R0 resection rates (p=0.272), lower pT stage (p<0.001), smaller number of metastastic lymph nodes (p=0.002), and lower incidence of lymph node metastasis (p=0.032) were noted in the CCRT(+)/Px group. The overall disease-specific survival were similar (median survival, 30.5 months (95% CI; 23.6-37.4) vs. 26.3 months (95% CI; 15.9-36.7), p=0.709), and no statistical differences in cancer recurrence risks were noted between the two groups (p=0.505). CONCLUSION: Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients.
Full Text
http://link.springer.com/article/10.1007%2Fs11605-011-1784-3
DOI
22183861
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 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, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90827
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