Outcomes after resection of locally advanced or borderline resectable pancreatic cancer after neoadjuvant therapy
Outcomes after resection of locally advanced or borderline resectable pancreatic cancer after neoadjuvant therapy
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DOI：
10.1016/j.amjsurg.2011.03.008
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发表时间：
2012-02-01
影响因子：
3
通讯作者：
Falconi, Massimo
中科院分区：
文献类型：
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作者：
Barugola, Giuliano;Partelli, Stefano;Falconi, Massimo
背景：新辅助治疗常用于不可切除/边缘可切除的胰腺癌。本研究的目的是回顾性比较局部晚期/边缘性可切除胰腺癌新辅助治疗后行胰腺切除术的患者的术后结局和生存率（新辅助治疗组）与那些接受前期手术的可切除疾病患者的比较。在2000年至2008年期间，有403名患者接受了胰腺癌切除术，41名（10.1%）患者接受了新辅助治疗，最初无法切除的肿瘤，362名（89.9%）患者接受了前期手术。结果：两组的死亡率/发病率相似。新辅助治疗组的淋巴结转移率明显较低（31.7% vs 86.2%; P <0.001）。新辅助治疗后，13.6%的患者观察到完全病理学缓解。新辅助治疗组和前期治疗组切除术后的中位疾病特异性生存期分别为35个月和27个月（P = 0.74）。在新辅助治疗组中，N 0/N1 patients.CONCLUSIONS的生存率相似：新辅助治疗后，术后死亡率和发病率没有显著增加。局部晚期胰腺癌的新辅助治疗可以导致客观的病理反应，但这并不能显著提高切除术后的生存率。(C)2012 Elsevier Inc. All rights reserved.
BACKGROUND: Neoadjuvant treatment frequently is performed in unresectable/borderline resectable pancreatic cancer. The aim of this study was to retrospectively compare postoperative outcomes and survival of patients who underwent pancreatectomy after neoadjuvant treatment for locally advanced/borderline resectable pancreatic cancer (neoadjuvant treatment group) with those of patients with resectable disease who underwent upfront surgery.METHODS: Between 2000 and 2008, there were 403 patients who underwent pancreatic cancer resection, 41 (10.1%) patients after neoadjuvant treatment for initially unresectable tumors and 362 (89.9%) patients had upfront surgery. Univariate and multivariable analyses were performed.RESULTS: Mortality/morbidity rates were similar in the 2 groups. Nodal metastases were significantly lower in the neoadjuvant treatment group (31.7% vs 86.2%; P < .001). A complete pathologic response was observed in 13.6% after neoadjuvant treatment. Median disease-specific survival from resection was 35 and 27 months in the neoadjuvant treatment and upfront groups, respectively (P = .74). In the neoadjuvant treatment group survival rates were similar in N0/N1 patients.CONCLUSIONS: Postoperative mortality and morbidity do not significantly increase after neoadjuvant treatment. Neoadjuvant treatment in locally advanced pancreatic cancer can lead to an objective pathologic response, but this does not significantly improve survival after resection. (C) 2012 Elsevier Inc. All rights reserved.