Vincent P Groot1, Hjalmar C van Santvoort2, Steffi J E Rombouts3, Jeroen Hagendoorn3, Inne H M Borel Rinkes3, Marco van Vulpen4, Joseph M Herman5, Christopher L Wolfgang6, Marc G Besselink7, I Quintus Molenaar8. 1. Dept. of Surgery, University Medical Center Utrecht Cancer Center, The Netherlands; Dept. of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Dept. of Surgery, St. Antonius Hospital Nieuwegein, The Netherlands; Dept. of Surgery, Academic Medical Center Amsterdam, The Netherlands. 3. Dept. of Surgery, University Medical Center Utrecht Cancer Center, The Netherlands. 4. Dept. of Radiation Oncology, University Medical Center Utrecht Cancer Center, The Netherlands. 5. Dept. of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Dept. of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 7. Dept. of Surgery, Academic Medical Center Amsterdam, The Netherlands. 8. Dept. of Surgery, University Medical Center Utrecht Cancer Center, The Netherlands. Electronic address: i.q.molenaar@umcutrecht.nl.
Abstract
BACKGROUND: The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients. METHODS: A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included. Primary endpoints were morbidity, mortality and survival after ILR treatment. RESULTS: After screening 1152 studies, 18 studies reporting on 313 patients undergoing treatment for ILR were included. Treatment options for ILR included surgical re-resection (8 studies, 100 patients), chemoradiotherapy (7 studies, 153 patients) and stereotactic body radiation therapy (SBRT) (4 studies, 60 patients). Morbidity and mortality were reported for re-resection (29% and 1%, respectively), chemoradiotherapy (54% and 0%) and SBRT (3% and 1%). Most patients had a prolonged disease-free interval before recurrence. Median survival after treatment of ILR of up to 32, 19 and 16 months was reported for re-resection, chemoradiotherapy and SBRT, respectively. CONCLUSION: In selected patients, treatment of ILR following pancreatic resection for pancreatic cancer seems safe, feasible and associated with relatively good survival.
BACKGROUND: The majority of patients who have undergone a pancreatic resection for pancreatic cancer develop disease recurrence within two years. In around 30% of these patients, isolated local recurrence (ILR) is found. The aim of this study was to systematically review treatment options for this subgroup of patients. METHODS: A systematic search was performed in PubMed, Embase and the Cochrane Library. Studies reporting on the treatment of ILR after initial curative-intent resection of primary pancreatic cancer were included. Primary endpoints were morbidity, mortality and survival after ILR treatment. RESULTS: After screening 1152 studies, 18 studies reporting on 313 patients undergoing treatment for ILR were included. Treatment options for ILR included surgical re-resection (8 studies, 100 patients), chemoradiotherapy (7 studies, 153 patients) and stereotactic body radiation therapy (SBRT) (4 studies, 60 patients). Morbidity and mortality were reported for re-resection (29% and 1%, respectively), chemoradiotherapy (54% and 0%) and SBRT (3% and 1%). Most patients had a prolonged disease-free interval before recurrence. Median survival after treatment of ILR of up to 32, 19 and 16 months was reported for re-resection, chemoradiotherapy and SBRT, respectively. CONCLUSION: In selected patients, treatment of ILR following pancreatic resection for pancreatic cancer seems safe, feasible and associated with relatively good survival.
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Roberto J Rivero-Soto; Jun Yu; Ammar A Javed; Richard A Burkhart; Inne H M Borel Rinkes; I Quintus Molenaar; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Date: 2018-03-23 Impact factor: 12.969
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Ding Ding; Ammar A Javed; Richard A Burkhart; Jun Yu; Inne H Borel Rinkes; I Quintus Molenaar; John L Cameron; Elliot K Fishman; Ralph H Hruban; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Oncol Date: 2018-06-14 Impact factor: 5.344
Authors: Vincent P Groot; Georgios Gemenetzis; Alex B Blair; Roberto J Rivero-Soto; Jun Yu; Ammar A Javed; Richard A Burkhart; Inne H M Borel Rinkes; I Quintus Molenaar; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Date: 2019-06 Impact factor: 13.787
Authors: Hitomi Sakamoto; Marc A Attiyeh; Jeffrey M Gerold; Alvin P Makohon-Moore; Akimasa Hayashi; Jungeui Hong; Rajya Kappagantula; Lance Zhang; Jerry P Melchor; Johannes G Reiter; Alexander Heyde; Craig M Bielski; Alexander V Penson; Mithat Gönen; Debyani Chakravarty; Eileen M O'Reilly; Laura D Wood; Ralph H Hruban; Martin A Nowak; Nicholas D Socci; Barry S Taylor; Christine A Iacobuzio-Donahue Journal: Cancer Discov Date: 2020-03-19 Impact factor: 38.272