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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 
Journal Title
Issue Date
Aged ; Carcinoma, Pancreatic Ductal/diagnostic imaging ; Carcinoma, Pancreatic Ductal/drug therapy ; Carcinoma, Pancreatic Ductal/mortality ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Pancreatic Ductal/surgery ; Carcinoma, Pancreatic Ductal/therapy* ; Chemoradiotherapy, Adjuvant/adverse effects ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoadjuvant Therapy/methods* ; Neoplasm Staging ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/radiotherapy ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms/therapy* ; Pancreaticoduodenectomy*/adverse effects ; Pancreaticoduodenectomy*/mortality ; Republic of Korea ; Retrospective Studies ; Survival Rate ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
uncinate process ; pancreatic cancer ; pancreatectomy ; preoperative chemoradiation
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
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, Jae Bock(정재복)
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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