Adjuvant surgical therapy for patients with initially-unresectable pancreatic cancer with long-term favorable responses to chemotherapy
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概要
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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.
- 2011-09-01
著者
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Shirato Hiroki
北海道大学 医学研究科耳鼻咽喉科･頭頸部外科学分野
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Matsumoto Joe
Department Of General Surgery Hakodate Central General Hospital
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Kondo Satoshi
斗南病院 外科
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Hirano Satoshi
北海道大学 医学研究科腫瘍外科学分野
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Kondoh Satoshi
Second Department Of Surgery Hokkaido University School Of Medicine
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Sugiura Hiroshi
Department Of Surgical Oncology Division Of Cancer Medicine Hokkaido University Graduate School Of M
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HIRANO SATOSHI
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
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Kondo Satoshi
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Kato Kentaro
Department Of Cellular And Molecular Medicine University Of Copenhagen
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TSUCHIKAWA Takahiro
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
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Hirano Satoshi
Department Of Electrical And Computer Engineering Nagoya Institute Of Technology
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Saito Katsunori
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Kato Kentaro
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Kondo Satoshi
Department Of Chemistry And Chemical Engineering Yamagata University
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Haba Shin
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Tanaka Eiichi
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Hirano Satoshi
Second Department Of Surgery Hokkaido University School Of Medicine
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Tanaka Eiichi
Department Of Applied Physics And Chemistry The University Of Electro-communications
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Shirato Hiroki
Department Of Diagnostic And Interventional Radiology Hokkaido University Hospital
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Shichinohe Toshiaki
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Matsumoto Joe
Division Of Cancer Diagnostics And Therapeutics Hokkaido University Graduate School Of Medicine
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Tanaka Eiichi
Division Of Cancer Diagnostics And Therapeutics Hokkaido University Graduate School Of Medicine
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Hirano Satoshi
Surgical Oncology Hokkaido University Graduate School Of Medicine
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TANAKA Eiichi
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
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