Adjuvant surgical therapy for patients with initially-unresectable pancreatic cancer with long-term favorable responses to chemotherapy

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Author(s)

    • KATO Kentaro
    • Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
    • KONDO Satoshi
    • Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
    • HIRANO Satoshi
    • Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
    • TANAKA Eiichi
    • Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
    • MATSUMOTO Joe
    • Department of Surgical Oncology, Hokkaido University Graduate School of Medicine

Abstract

Background: To evaluate the prognostic impact of surgical intervention for initially-unresectable pancreatic ductal adenocarcinomas with long-term favorable responses to chemotherapy. Method: Twelve patients with initially-unresectable pancreatic ductal carcinomas who underwent radical surgery after a favorable response to chemotherapy for six months or longer in principle were enrolled in this study. We retrospectively reviewed the charts of these 12 patients and performed a survival analysis. Results: Initially, the included patients were unable to undergo resection secondary to locally-advanced disease in eight patients and metastatic disease in four patients. The length of preoperative therapy was five to 44 months (median 12). The operative procedure included resection of the area initially involved by tumor and regional major vessels. The postoperative mortality and morbidity rates were 0% and 50%, respectively. R0 resection was achieved in nine patients (75%) and pathological CR was seen in one patient. Estimated overall five-year survival from initial therapy was 50.0%. The survival rate (0% at 5 years) of the four patients with metastatic disease as the cause of initial unresectability was significantly worse than that (100% at 5 years) of the eight patients with locally-advanced disease (P = 0.0014). Conclusion: Surgical intervention should be considered for patients with initially-unresectable pancreatic cancers who demonstrate long-term favorable responses to chemotherapy. R0 resection may significantly contribute to cure, especially in patients with initially locally-advanced disease. Large cohort prospective studies will be necessary to demonstrate the efficacy of this strategy.

Journal

  • Journal of Hepato-Biliary-Pancreatic Sciences

    Journal of Hepato-Biliary-Pancreatic Sciences 18(5), 712-716, 2011-09-01

    Springer Japan

References:  17

Cited by:  2

Codes

  • NII Article ID (NAID)
    10029688537
  • NII NACSIS-CAT ID (NCID)
    AA12507209
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    18686974
  • Data Source
    CJP  CJPref  IR 
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