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

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Title: Adjuvant surgical therapy for patients with initially-unresectable pancreatic cancer with long-term favorable responses to chemotherapy
Authors: Kato, Kentaro Browse this author →KAKEN DB
Kondo, Satoshi Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Tanaka, Eiichi Browse this author →KAKEN DB
Shichinohe, Toshiaki Browse this author →KAKEN DB
Tsuchikawa, Takahiro Browse this author
Matsumoto, Joe Browse this author
Keywords: Unresectable pancreatic cancer
Chemotherapy
Adjuvant surgery
Issue Date: Sep-2011
Publisher: Springer Japan
Journal Title: Journal of Hepato-Biliary-Pancreatic Sciences
Volume: 18
Issue: 5
Start Page: 712
End Page: 716
Publisher DOI: 10.1007/s00534-011-0391-8
PMID: 21455748
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.
Rights: The original publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/47042
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 松本 譲

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