OBJECTIVE: The treatment of locally advanced unresectable pancreatic cancer remains extremely challenging, particularly as the efficacy of concurrent chemoradiotherapy (CRT) remains unclear. METHODS: We studied 93 patients (8.0%) with locally advanced unresectable pancreatic cancer without distant metastases from among a total group of 1168 patients who were diagnosed with pancreatic cancer from March 2005 to November 2015 at the Kochi Health Sciences Center, Kochi, Japan. We therefore evaluated the clinical efficacy of CRT in patients with locally advanced unresectable pancreatic cancer. RESULTS: Of the 93 patients with locally advanced unresectable pancreatic cancer, 35 patients (37.6%) were subsequently classified as having resectable disease following CRT. The median overall survival of patients who received CRT alone for locally advanced unresectable pancreatic cancer was 8.0 months, and all died within 3 years. On the other hand, the overall 1-, 3- and 5-year survival rates in patients who were reclassified as having resectable tumour after CRT were 71.3%, 39.2% and 23.5%, respectively. Our pathological assessments after surgical resection suggested that CRT might be associated with a significant reduction in the risk of lymph node metastases in patients with locally advanced unresectable pancreatic cancer. CONCLUSION: The results of this study suggested that CRT is clinically effective in improving survival, particularly in association with the resultant possibility of curative resection. Advances in knowledge: The best treatment strategy for patients with locally advanced unresectable pancreatic cancer is the subject of considerable debate, and CRT is only recommended if cancer has only grown around the pancreas without any distant metastases.
OBJECTIVE: The treatment of locally advanced unresectable pancreatic cancer remains extremely challenging, particularly as the efficacy of concurrent chemoradiotherapy (CRT) remains unclear. METHODS: We studied 93 patients (8.0%) with locally advanced unresectable pancreatic cancer without distant metastases from among a total group of 1168 patients who were diagnosed with pancreatic cancer from March 2005 to November 2015 at the Kochi Health Sciences Center, Kochi, Japan. We therefore evaluated the clinical efficacy of CRT in patients with locally advanced unresectable pancreatic cancer. RESULTS: Of the 93 patients with locally advanced unresectable pancreatic cancer, 35 patients (37.6%) were subsequently classified as having resectable disease following CRT. The median overall survival of patients who received CRT alone for locally advanced unresectable pancreatic cancer was 8.0 months, and all died within 3 years. On the other hand, the overall 1-, 3- and 5-year survival rates in patients who were reclassified as having resectable tumour after CRT were 71.3%, 39.2% and 23.5%, respectively. Our pathological assessments after surgical resection suggested that CRT might be associated with a significant reduction in the risk of lymph node metastases in patients with locally advanced unresectable pancreatic cancer. CONCLUSION: The results of this study suggested that CRT is clinically effective in improving survival, particularly in association with the resultant possibility of curative resection. Advances in knowledge: The best treatment strategy for patients with locally advanced unresectable pancreatic cancer is the subject of considerable debate, and CRT is only recommended if cancer has only grown around the pancreas without any distant metastases.
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Authors: John P Neoptolemos; Daniel H Palmer; Paula Ghaneh; Eftychia E Psarelli; Juan W Valle; Christopher M Halloran; Olusola Faluyi; Derek A O'Reilly; David Cunningham; Jonathan Wadsley; Suzanne Darby; Tim Meyer; Roopinder Gillmore; Alan Anthoney; Pehr Lind; Bengt Glimelius; Stephen Falk; Jakob R Izbicki; Gary William Middleton; Sebastian Cummins; Paul J Ross; Harpreet Wasan; Alec McDonald; Tom Crosby; Yuk Ting Ma; Kinnari Patel; David Sherriff; Rubin Soomal; David Borg; Sharmila Sothi; Pascal Hammel; Thilo Hackert; Richard Jackson; Markus W Büchler Journal: Lancet Date: 2017-01-25 Impact factor: 79.321
Authors: Ioannis T Konstantinidis; Andrew L Warshaw; Jill N Allen; Lawrence S Blaszkowsky; Carlos Fernandez-Del Castillo; Vikram Deshpande; Theodore S Hong; Eunice L Kwak; Gregory Y Lauwers; David P Ryan; Jennifer A Wargo; Keith D Lillemoe; Cristina R Ferrone Journal: Ann Surg Date: 2013-04 Impact factor: 12.969
Authors: R Alvarez; M Musteanu; E Garcia-Garcia; P P Lopez-Casas; D Megias; C Guerra; M Muñoz; Y Quijano; A Cubillo; J Rodriguez-Pascual; C Plaza; E de Vicente; S Prados; S Tabernero; M Barbacid; F Lopez-Rios; M Hidalgo Journal: Br J Cancer Date: 2013-08-01 Impact factor: 7.640
Authors: Georgios Gemenetzis; Vincent P Groot; Alex B Blair; Daniel A Laheru; Lei Zheng; Amol K Narang; Elliot K Fishman; Ralph H Hruban; Jun Yu; Richard A Burkhart; John L Cameron; Matthew J Weiss; Christopher L Wolfgang; Jin He Journal: Ann Surg Date: 2019-08 Impact factor: 12.969