PURPOSE: The aim of this study was to evaluate the efficacy of neoadjuvant gemcitabine plus S-1 (GS) chemotherapy as measured by overall survival for patients with pancreatic carcinoma with arterial contact. METHODS: Medical records of 77 patients with pancreatic carcinoma with arterial contact who intended to undergo tumor resection were analyzed retrospectively. These patients were divided into two groups: patients who underwent upfront surgery and patients who underwent tumor resection after neoadjuvant GS chemotherapy. Clinicopathological factors were compared between the two groups. RESULTS: Of the 77 patients, 25 patients underwent upfront surgery while the remaining 52 patients received neoadjuvant GS chemotherapy. Seven patients did not undergo tumor resection due to distant metastasis. No serious adverse effects associated with neoadjuvant GS chemotherapy were observed. The R0 resection rate of patients who received neoadjuvant GS chemotherapy was significantly higher than that of patients who did not (P < 0.001). Overall survival of patients who received neoadjuvant GS chemotherapy was significantly longer than that of patients who did not among all 77 patients (P = 0.003, median survival time, 27.1 vs. 11.6 months) as well as among the 70 patients who underwent tumor resection (P = 0.001, median survival time, 27.2 vs. 11.6 months). Multivariate analysis demonstrated that neoadjuvant GS chemotherapy was an independent prognostic factor of overall survival for patients who underwent tumor resection (P = 0.019). CONCLUSIONS: Neoadjuvant GS chemotherapy may provide a survival benefit to patients with pancreatic carcinoma with arterial contact.
PURPOSE: The aim of this study was to evaluate the efficacy of neoadjuvant gemcitabine plus S-1 (GS) chemotherapy as measured by overall survival for patients with pancreatic carcinoma with arterial contact. METHODS: Medical records of 77 patients with pancreatic carcinoma with arterial contact who intended to undergo tumor resection were analyzed retrospectively. These patients were divided into two groups: patients who underwent upfront surgery and patients who underwent tumor resection after neoadjuvant GS chemotherapy. Clinicopathological factors were compared between the two groups. RESULTS: Of the 77 patients, 25 patients underwent upfront surgery while the remaining 52 patients received neoadjuvant GS chemotherapy. Seven patients did not undergo tumor resection due to distant metastasis. No serious adverse effects associated with neoadjuvant GS chemotherapy were observed. The R0 resection rate of patients who received neoadjuvant GS chemotherapy was significantly higher than that of patients who did not (P < 0.001). Overall survival of patients who received neoadjuvant GS chemotherapy was significantly longer than that of patients who did not among all 77 patients (P = 0.003, median survival time, 27.1 vs. 11.6 months) as well as among the 70 patients who underwent tumor resection (P = 0.001, median survival time, 27.2 vs. 11.6 months). Multivariate analysis demonstrated that neoadjuvant GS chemotherapy was an independent prognostic factor of overall survival for patients who underwent tumor resection (P = 0.019). CONCLUSIONS: Neoadjuvant GS chemotherapy may provide a survival benefit to patients with pancreatic carcinoma with arterial contact.
Authors: E Versteijne; J A Vogel; M G Besselink; O R C Busch; J W Wilmink; J G Daams; C H J van Eijck; B Groot Koerkamp; C R N Rasch; G van Tienhoven Journal: Br J Surg Date: 2018-04-30 Impact factor: 6.939