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- Title
Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy.
- Authors
Addeo, Pietro; Rosso, Edoardo; Fuchshuber, Pascal; Oussoultzoglou, Elie; De Blasi, Vito; Simone, Gael; Belletier, Christine; Dufour, Patrick; Bachellier, Philippe
- Abstract
Objective: To report the outcomes of surgical resection of borderline resectable (BL) and locally advanced (LA) 'unresectable' pancreatic cancer after neoadjuvant chemotherapy. Methods: A review of a prospectively maintained database for pancreatic resections was undertaken to identify patients undergoing resection for BL and LA pancreatic cancer after neoadjuvant chemotherapy between January 2007 and December 2012. Clinicopathological, surgical and survival outcomes were analyzed. Results: A total of 45 patients with LA (n = 34) or BL cancer (n = 11) underwent surgery after a mean (± SD) of 7 ± 4 preoperative chemotherapy cycles. Ninety-day mortality was 6.7%, and overall morbidity was 33.3%. An R0 resection was achieved in 34 patients, and 4 patients showed a complete pathological response. Overall median postoperative survival was 17 months (21 after the start of neoadjuvant treatment). Overall and disease-free survival was 74.9 and 43.6% at 1 year and 21.2 and 10.3% at 3 years, respectively. In BL cancer patients, the 3-year survival was significantly higher compared to that of LA cancer patients (p = 0.02). Conclusions: Curative intent resection in BL and LA cancer patients after neoadjuvant chemotherapy can be achieved with reasonable mortality and morbidity and an encouraging 3-year survival. After neoadjuvant therapy, resection provides a better overall survival for BL compared to LA cancer patients. © 2015 S. Karger AG, Basel
- Subjects
FRANCE; ACADEMIC medical centers; ADENOCARCINOMA; CHI-squared test; COMBINED modality therapy; FISHER exact test; LONGITUDINAL method; PANCREATIC tumors; T-test (Statistics); LOGISTIC regression analysis; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; MANN Whitney U Test
- Publication
Oncology, 2015, Vol 89, Issue 1, p37
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000371745