Chemoradiation followed by chemotherapy before resection for borderline pancreatic adenocarcinoma
Abstract Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. Methods A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative c...
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| Published in: | The American journal of surgery Vol. 195; no. 3; pp. 318 - 321 |
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| Abstract | Abstract Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. Methods A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. Results Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis ≤60% was associated with recurrence and poor survival. Conclusions Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. |
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| AbstractList | BACKGROUNDFor patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival.METHODSA retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival.RESULTSThirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis < or = 60% was associated with recurrence and poor survival.CONCLUSIONSPreoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis < or = 60% was associated with recurrence and poor survival. Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. Methods A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. Results Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis ≤60% was associated with recurrence and poor survival. Conclusions Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. Abstract Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. Methods A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. Results Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis ≤60% was associated with recurrence and poor survival. Conclusions Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival. Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis ≤60% was associated with recurrence and poor survival. Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival. |
| Author | Konski, Andre, M.D Cohen, Steven J., M.D Li, Tiaynu, M.S Hoffman, John P., M.D Davidson, Marson, M.D Siripurapu, Veeriah, M.D Ciocca, Vince, M.D Brown, Kimberly M., M.D Watson, James C., M.D Cooper, Harry, M.D |
| Author_xml | – sequence: 1 fullname: Brown, Kimberly M., M.D – sequence: 2 fullname: Siripurapu, Veeriah, M.D – sequence: 3 fullname: Davidson, Marson, M.D – sequence: 4 fullname: Cohen, Steven J., M.D – sequence: 5 fullname: Konski, Andre, M.D – sequence: 6 fullname: Watson, James C., M.D – sequence: 7 fullname: Li, Tiaynu, M.S – sequence: 8 fullname: Ciocca, Vince, M.D – sequence: 9 fullname: Cooper, Harry, M.D – sequence: 10 fullname: Hoffman, John P., M.D |
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| Keywords | Chemotherapy Borderline resectable Pancreatic cancer Chemoradiation Neoadjuvant Pancreas Cancer Resection Surgical resection Malignant tumor Radiotherapy Chemoradiotherapy Personality disorder Neoadjuvant treatment Medicine Treatment Surgery Pancreas cancer Digestive diseases Combined treatment Pancreas adenocarcinoma Pancreatic disease |
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| Snippet | Abstract Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0... For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved... Background For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and... BACKGROUNDFor patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and... |
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| SubjectTerms | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adenocarcinoma - therapy Adult Aged Antineoplastic Agents - administration & dosage Biological and medical sciences Borderline resectable Cancer Cancer therapies Chemoradiation Chemotherapy Chemotherapy, Adjuvant Female Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical imaging Medical sciences Middle Aged Mortality Neoadjuvant Neoadjuvant Therapy Neoplasm Staging Pancreas Pancreatic cancer Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Pancreatic Neoplasms - surgery Pancreatic Neoplasms - therapy Pancreaticoduodenectomy Patients Radiotherapy, Adjuvant Retrospective Studies Statistical analysis Surgery Treatment Outcome Tumors |
| Title | Chemoradiation followed by chemotherapy before resection for borderline pancreatic adenocarcinoma |
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