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Pancreatoduodenectomy following neoadjuvant chemoradiation therapy in uncinate process pancreatic cancer.

 Kang, Chang Moo  ;  Choi, Jin-Young  ;  Seong, Jin Sil  ;  Song, Si Young  ;  Lee, Woo Jung  ;  Kim, Myung-Jin  ;  Chung, Jae Bock 
 Pancreas, Vol.41(3) : 467-473, 2012 
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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.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실)
Yonsei Authors
강창무(Kang, Chang Moo) ; 김명진(Kim, Myeong Jin) ; 성진실(Seong, Jin Sil) ; 송시영(Song, Si Young) ; 이우정(Lee, Woo Jung) ; 정재복(Chung, Jae Bock) ; 최진영(Choi, Jin Young)
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