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Role of adjuvant surgery in initially unresectable pancreatic cancer after long‐term chemotherapy or chemoradiation therapy: survival benefit?
Author(s) -
Opendro Singh Sapam,
Satoi Sohei,
Yanagimoto Hiroaki,
Yamamoto Tomohisa,
Toyokawa Hideyoshi,
Hirooka Satoshi,
Yamaki So,
Inoue Kentaro,
Matsui Yoichi,
Kwon AHon
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.119
Subject(s) - medicine , pancreatic cancer , adjuvant , concomitant , surgery , adjuvant therapy , chemotherapy , cancer , oncology
Background The purpose of the present study was to analyze the survival benefit and safety of adjuvant surgery in patients with initially unresectable pancreatic cancer following chemo(radio)therapy. Methods The 130 patients with unresectable pancreatic cancer treated during 2006 to 2013 were divided into a study group (15 patients) with planned adjuvant surgery, and a control group (115 patients with locally advanced disease) without adjuvant surgery. Results The study group of 15 patients had shrunken tumor, decreased tumor marker, and maintained performance status after 9 months (range 5–18 months) of chemo(radio)therapy. Thirteen patients had curative resection and two patients were not resected. The remaining controls of 115 patients did not undergo surgical resection due to poor response to chemo(radio)therapy or performance status. The median survival time in the study group was better than in the control group (36 vs. 9 months, P < 0.001). The mortality and morbidity rates in the study group were 0% and 46% respectively, in spite of concomitant organ resections in 77%. Conclusion Patients who had adjuvant surgery had significant improvement of survival without increase in morbidity and mortality, relative to patients with locally advanced disease. Thus, adjuvant surgery may provide the promising results in this group who responded favorably to initial chemo(radio)therapy in unresectable pancreatic cancer.