Role of adjuvant surgery in initially unresectable pancreatic cancer after long-term chemotherapy or chemoradiation therapy: survival benefit?

2014 ◽  
Vol 21 (9) ◽  
pp. 695-702 ◽  
Author(s):  
Singh Sapam Opendro ◽  
Sohei Satoi ◽  
Hiroaki Yanagimoto ◽  
Tomohisa Yamamoto ◽  
Hideyoshi Toyokawa ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Survival Benefit ◽  
Chemoradiation Therapy ◽  
Unresectable Pancreatic Cancer ◽  
Adjuvant Surgery

Role of Conversion Surgery for Unresectable Pancreatic Cancer After Long-Term Chemotherapy

2020 ◽  
Vol 44 (8) ◽  
pp. 2752-2760
Author(s):  
Nobuhiro Tsuchiya ◽  
Ryusei Matsuyama ◽  
Takashi Murakami ◽  
Yasuhiro Yabushita ◽  
Yu Sawada ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Unresectable Pancreatic Cancer ◽  
Conversion Surgery

scholarly journals Role of Radiofrequency Ablation in the Management of Unresectable Pancreatic Cancer

2021 ◽  
Vol 7 ◽  
Author(s):  
Muhammad Nadeem Yousaf ◽  
Hamid Ehsan ◽  
Ahmad Muneeb ◽  
Ahsan Wahab ◽  
Muhammad K. Sana ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiofrequency Ablation ◽  
Surgical Resection ◽  
Retrospective Studies ◽  
Advanced Disease ◽  
Protein Denaturation ◽  
Solid Organ ◽  
Unresectable Pancreatic Cancer ◽  
The Past

Pancreatic cancer is one of the most aggressive malignancies of the digestive tract and carries a poor prognosis. The majority of patients have advanced disease at the time of diagnosis. Surgical resection offers the only curative treatment, but only a small proportion of patients can undergo surgical resection. Radiofrequency ablation (RFA) is a well-known modality in the management of solid organ tumors, however, its utility in the management of pancreatic cancer is under investigation. Since the past decade, there is increasing use of RFA as it provides a feasible palliation treatment in the management of unresectable pancreatic cancer. RFA causes tumor cytoreduction through multiple mechanisms such as coagulative necrosis, protein denaturation, and activation of anticancer immunity. The safety profile of RFA is controversial because of the high risk for complications, however, small prospective and retrospective studies have shown promising results in its applicability for palliative management of unresectable pancreatic malignancies. In this review, we discuss different approaches of RFA, their indications, technical accessibility, safety, and major complications in the management of unresectable pancreatic cancer.

scholarly journals Current Role of Surgery in Pancreatic Cancer With Synchronous Liver Metastasis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482097659
Author(s):  
Wentao Zhou ◽  
Dansong Wang ◽  
Wenhui Lou
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Synchronous Liver Metastasis ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Current Guidelines

Pancreatic cancer with synchronous liver metastasis has an extremely poor prognosis, and surgery is not recommended for such patients by the current guidelines. However, an increasing body of studies have shown that concurrent resection of pancreatic cancer and liver metastasis is not only technically feasible but also beneficial to the survival in the selected patients. In this review, we aim to summarize the short- and long-term outcomes following synchronous liver metastasectomy for pancreatic cancer patients, and discuss the potential criteria in selecting appropriate surgical candidates, which might be helpful in clinical decision-making.

Long-term outocomes of preoperative chemoradiation therapy with gemcitabine and accelerated hyperfractionated radiation for respectable pancreatic cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14004-14004
Author(s):  
S. Nakamori ◽  
S. Nakahira ◽  
A. Miyamoto ◽  
S. Marubashi ◽  
H. Nagano ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Local Recurrence ◽  
Preoperative Chemoradiation ◽  
Chemoradiation Therapy ◽  
Control Group ◽  
R0 Resection ◽  
Survival Times ◽  
Resectable Pancreatic Cancer ◽  
Preoperative Chemoradiation Therapy

14004 Background: Gemcitabine (GEM) is recognized as an effective chemotherapeutic agent for non-curative pancreatic cancer and has an activity for radiosensitizer. Although preoperative chemoradiation therapy (preCRT) with GEM is one of the promising adjuvant therapies for potentially curative pancreatic cancer, the clinical significance of the treatment remains to obscure. Methods: Potentially resectable pancreatic cancer patients were recruited in this study from September 2001 through August 2004. Patients were randomly divided into preCRT group and a control group. Patients in preCRT group received GEM (400 mg/m2 or 800 mg/m2 on day 1 and 7) and concomitant accelerated hyperfractionated irradiation (1.5 Gy ×2/day, 5 days/weeks, total dose 30Gy or 36 Gy). After 3–4 weeks’ rest of the preCRT, patients were re-evaluated for resectability. Patients who underwent R0 resection did not received any postoperative adjuvant treatment until recurrence. Results: There were 23 patients in preCRT group and were 19 patients in control group. After re-evaluation, 4 patients (17%) were considered as unresectable due to the progressed disease. 19 patients (83%) in preCRT group and 19 patients (100%) in control group underwent laparotomy. Sixteen patients (70%) in preCRT group and 17 patients (89%) in control group underwent R0 resection. Median survival times were 17.6 months in preCRT group and 16.7 months in control group, respectively (p=0.65). Among patients underwent R0 resection, one and three-years survival rate were 81.2% and 27.1% in preCRT group, while these were 70.6% and 15.4% in the control group (p=0.26). Local recurrence was observed in 4 (25%) of 16 patients who underwent R0 resection in preCRT group and in 7 (41%) of 17 patients who underwent R0 resection in control group, while recurrence at distant organs (liver, lung, peritoneum, bone) were observed in 8 patients (50%) of preCRT group and 8 patients (47%) in control group. Conclusions: Although the preoperative chemoradiation therapy with GEM and accelerated hyperfractionated radiation for potentially curative pancreatic cancer is likely to be promising against local recurrence after R0 resection, survival benefit of the therapy was unsatisfactory. No significant financial relationships to disclose.

Clinical efficacy of adjuvant surgery following systemic treatments in patients with initially unresectable pancreatic cancer: Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 255-255
Author(s):  
Satoshi Hirano ◽  
Sohei Satoi ◽  
Hiroki Yamaue ◽  
Kentaro Kato ◽  
Shinichiro Takahashi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Surgical Resection ◽  
Initial Treatment ◽  
Multimodal Treatment ◽  
Control Group ◽  
Unresectable Pancreatic Cancer ◽  
Adjuvant Surgery ◽  
Surgery Group ◽  
Systemic Treatments

255 Background: Medical oncologists or pancreatic surgeons have identified candidates for surgical resection in patients with initially unresectable pancreatic cancer who favorably responded to multimodal treatment. Additional surgical resection during multimodal treatment, is called “adjuvant surgery”. A multicenter survey was conducted to explore the clinical efficacy of adjuvant surgery for initially unresectable pancreatic cancer with a long-term favorable response to systemic treatments. Methods: Clinical data, including the primary endpoint of overall survival were retrospectively compared between 58 initially unresectable pancreatic cancer patients that underwent adjuvant surgery with a favorable response to non-surgical cancer treatments over 6 months after the initial treatment (adjuvant surgery group) and 101 patients who did not undergo adjuvant surgery (control group). Results: The median observation periods were 51 months (20-122) in the control group, and 54 months (26-125) in the adjuvant surgery group, respectively. The actuarial survival rate at 1, 3, and 5 years after initial treatment in adjuvant surgery group (95, 53, and 34%) was significantly better than that in control group (88, 18, and 10%, p<0.0001). The propensity score analysis to provide adjustment of significant differences in the clinical backgrounds between the two groups revealed that adjuvant surgery was a significant independent prognostic variable with an adjusted hazard ratio (95% confidential interval) of 0.569 (0.36-0.89). Subgroup analysis according to the time from initial treatment to surgical resection showed a significant favorable difference in the overall survival in patients who underwent adjuvant surgery over 240 days after the initial treatment. Conclusions: The adjuvant surgery can occupy an important position in the multimodal therapy for patients with initially unresectable pancreatic cancer. The overall survival rate from the initial treatment is extremely high, especially in patients who received systemic treatments for more than 240 days.

Resection after preoperative chemotherapy or chemoradiation therapy for unresectable pancreatic cancer – Single center experience

Pancreatology ◽  
2013 ◽  
Vol 13 (4) ◽  
pp. S42
Author(s):  
Yoshikazu Toyoki ◽  
Keinosuke Ishido ◽  
Daisuke Kudo ◽  
Norihisa Kimura ◽  
Taiichi Wakiya ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Preoperative Chemotherapy ◽  
Chemoradiation Therapy ◽  
Unresectable Pancreatic Cancer ◽  
Single Center ◽  
Single Center Experience
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