Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer

ChangMoo Kang, Yong Eun Chung, Jeong Youp Park, Jinsil Seong, Ho Kyoung Hwang, Hye Jin Choi, Hyunki Kim, Si Young Song, Woo Jung Lee

Research output: Contribution to journalArticle

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Abstract

Background: Margin-negative pancreatectomy provides only chance to cure pancreatic cancer. However, borderline resectable pancreatic cancer (BRPCa) has the risk of incomplete palliative resection. Materials and Methods: We retrospectively reviewed 32 patients with BRPCa who underwent a pancreatectomy following preoperative chemoradiation therapy (CCRT (+)/Px group) and compared these patients with those with resectable pancreatic cancer (RPCa) who underwent pancreatectomy without preoperative CCRT (CCRT (-)/Px group, n = 104). Results: Eighteen patients (56. 2%) showed more than 50% significant pathological response to CCRT. The degree of pathological responses showed a positive relationship between final pT stage (p = 0. 075). More frequent vascular resection (p < 0. 001), transfusion (p = 0. 076), and longer operation time were observed in the CCRT(+)/Px group. However, similar R0 resection rates (p = 0. 272), lower pT stage (p < 0. 001), smaller number of metastastic lymph nodes (p = 0. 002), and lower incidence of lymph node metastasis (p = 0. 032) were noted in the CCRT(+)/Px group. The overall disease-specific survival were similar (median survival, 30. 5 months (95% CI; 23. 6-37. 4) vs. 26. 3 months (95% CI; 15. 9-36. 7), p = 0. 709), and no statistical differences in cancer recurrence risks were noted between the two groups (p = 0. 505). Conclusion: Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients.

Original languageEnglish
Pages (from-to)509-517
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume16
Issue number3
DOIs
Publication statusPublished - 2012 Mar 1

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Pancreatic Neoplasms
Pancreatectomy
Lymph Nodes
Therapeutics
Survival
Blood Vessels
Margins of Excision
Neoplasm Metastasis
Recurrence
Incidence
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Kang, ChangMoo ; Chung, Yong Eun ; Park, Jeong Youp ; Seong, Jinsil ; Hwang, Ho Kyoung ; Choi, Hye Jin ; Kim, Hyunki ; Song, Si Young ; Lee, Woo Jung. / Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer. In: Journal of Gastrointestinal Surgery. 2012 ; Vol. 16, No. 3. pp. 509-517.
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title = "Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer",
abstract = "Background: Margin-negative pancreatectomy provides only chance to cure pancreatic cancer. However, borderline resectable pancreatic cancer (BRPCa) has the risk of incomplete palliative resection. Materials and Methods: We retrospectively reviewed 32 patients with BRPCa who underwent a pancreatectomy following preoperative chemoradiation therapy (CCRT (+)/Px group) and compared these patients with those with resectable pancreatic cancer (RPCa) who underwent pancreatectomy without preoperative CCRT (CCRT (-)/Px group, n = 104). Results: Eighteen patients (56. 2{\%}) showed more than 50{\%} significant pathological response to CCRT. The degree of pathological responses showed a positive relationship between final pT stage (p = 0. 075). More frequent vascular resection (p < 0. 001), transfusion (p = 0. 076), and longer operation time were observed in the CCRT(+)/Px group. However, similar R0 resection rates (p = 0. 272), lower pT stage (p < 0. 001), smaller number of metastastic lymph nodes (p = 0. 002), and lower incidence of lymph node metastasis (p = 0. 032) were noted in the CCRT(+)/Px group. The overall disease-specific survival were similar (median survival, 30. 5 months (95{\%} CI; 23. 6-37. 4) vs. 26. 3 months (95{\%} CI; 15. 9-36. 7), p = 0. 709), and no statistical differences in cancer recurrence risks were noted between the two groups (p = 0. 505). Conclusion: Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients.",
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Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer. / Kang, ChangMoo; Chung, Yong Eun; Park, Jeong Youp; Seong, Jinsil; Hwang, Ho Kyoung; Choi, Hye Jin; Kim, Hyunki; Song, Si Young; Lee, Woo Jung.

In: Journal of Gastrointestinal Surgery, Vol. 16, No. 3, 01.03.2012, p. 509-517.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer

AU - Kang, ChangMoo

AU - Chung, Yong Eun

AU - Park, Jeong Youp

AU - Seong, Jinsil

AU - Hwang, Ho Kyoung

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AU - Kim, Hyunki

AU - Song, Si Young

AU - Lee, Woo Jung

PY - 2012/3/1

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N2 - Background: Margin-negative pancreatectomy provides only chance to cure pancreatic cancer. However, borderline resectable pancreatic cancer (BRPCa) has the risk of incomplete palliative resection. Materials and Methods: We retrospectively reviewed 32 patients with BRPCa who underwent a pancreatectomy following preoperative chemoradiation therapy (CCRT (+)/Px group) and compared these patients with those with resectable pancreatic cancer (RPCa) who underwent pancreatectomy without preoperative CCRT (CCRT (-)/Px group, n = 104). Results: Eighteen patients (56. 2%) showed more than 50% significant pathological response to CCRT. The degree of pathological responses showed a positive relationship between final pT stage (p = 0. 075). More frequent vascular resection (p < 0. 001), transfusion (p = 0. 076), and longer operation time were observed in the CCRT(+)/Px group. However, similar R0 resection rates (p = 0. 272), lower pT stage (p < 0. 001), smaller number of metastastic lymph nodes (p = 0. 002), and lower incidence of lymph node metastasis (p = 0. 032) were noted in the CCRT(+)/Px group. The overall disease-specific survival were similar (median survival, 30. 5 months (95% CI; 23. 6-37. 4) vs. 26. 3 months (95% CI; 15. 9-36. 7), p = 0. 709), and no statistical differences in cancer recurrence risks were noted between the two groups (p = 0. 505). Conclusion: Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients.

AB - Background: Margin-negative pancreatectomy provides only chance to cure pancreatic cancer. However, borderline resectable pancreatic cancer (BRPCa) has the risk of incomplete palliative resection. Materials and Methods: We retrospectively reviewed 32 patients with BRPCa who underwent a pancreatectomy following preoperative chemoradiation therapy (CCRT (+)/Px group) and compared these patients with those with resectable pancreatic cancer (RPCa) who underwent pancreatectomy without preoperative CCRT (CCRT (-)/Px group, n = 104). Results: Eighteen patients (56. 2%) showed more than 50% significant pathological response to CCRT. The degree of pathological responses showed a positive relationship between final pT stage (p = 0. 075). More frequent vascular resection (p < 0. 001), transfusion (p = 0. 076), and longer operation time were observed in the CCRT(+)/Px group. However, similar R0 resection rates (p = 0. 272), lower pT stage (p < 0. 001), smaller number of metastastic lymph nodes (p = 0. 002), and lower incidence of lymph node metastasis (p = 0. 032) were noted in the CCRT(+)/Px group. The overall disease-specific survival were similar (median survival, 30. 5 months (95% CI; 23. 6-37. 4) vs. 26. 3 months (95% CI; 15. 9-36. 7), p = 0. 709), and no statistical differences in cancer recurrence risks were noted between the two groups (p = 0. 505). Conclusion: Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients.

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