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Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment

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Title: Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment
Authors: Asano, Toshimichi Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Nakamura, Toru Browse this author →KAKEN DB
Okamura, Keisuke Browse this author →KAKEN DB
Tsuchikawa, Takahiro Browse this author →KAKEN DB
Noji, Takehiro Browse this author →KAKEN DB
Nakanishi, Yoshitsugu Browse this author →KAKEN DB
Tanaka, Kimitaka Browse this author →KAKEN DB
Shichinohe, Toshiaki Browse this author →KAKEN DB
Keywords: Conversion surgery
Multidisciplinary treatment
Prognosis
Survival analysis
Unresectable pancreatic cancer
Issue Date: Jul-2018
Publisher: John Wiley & Sons
Journal Title: Journal of hepato-biliary-pancreatic sciences
Volume: 25
Issue: 7
Start Page: 342
End Page: 350
Publisher DOI: 10.1002/jhbp.565
PMID: 29797499
Abstract: Background: Conversion surgery (CS) is expected as a new therapeutic strategy for patients with unresectable pancreatic cancer (UR-PC). We analyzed outcomes of CS for patients with UR-PC and evaluated the survival benefit of CS. Methods: Thirty-four patients diagnosed with UR-PC according to the National Comprehensive Cancer Network guideline underwent CS in our hospital. Resectability was considered by multimodal images in patients who underwent nonsurgical treatment (NST) for more than 6 months. CS was performed only in patients who were judged to be able to undergo R0 resection. Results: Twenty-six patients had locally advanced PC, and eight had distant metastases. The median duration of NST was 9 (range 5-44) months. R0 resection was achieved in 30 patients (88.2%). Six patients (17.6%) showed Evans grade ≥III. Three- and 5-year overall survival (OS) rates from initial treatment were 74% and 56.9%, respectively, with median survival time (MST) of 5.3 years. The actual 5-year OS rate in 19 patients was 47.4% with an MST of 4.0 years. Patients with Evans grade ≥III had a better prognosis than those with Evans grade <III (P = 0.0092, log-rank test). Conclusions: Conversion surgery might have survival benefits to patients with UR-PC who responded favorably to NST.
Rights: This is the peer reviewed version of the following article: Asano, T., Hirano, S., Nakamura, T., Okamura, K., Tsuchikawa, T., Noji, T., Nakanishi, Y., Tanaka, K. and Shichinohe, T. (2018), Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment. J Hepatobiliary Pancreat Sci, 25: 342-350., which has been published in final form at https://doi.org/10.1002/jhbp.565. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Type: article (author version)
URI: http://hdl.handle.net/2115/74831
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 浅野 賢道

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