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Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer

Survival remains poor even after resection of pancreatic cancer and the postoperative recurrence rate is extremely high. Thus, neoadjuvant treatment may improve outcomes for resectable pancreatic cancer (RPC). This study evaluated the efficacy of neoadjuvant therapy for radiologically judged RPC. A...

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Autores principales: Okabayashi, Takehiro, Sui, Kenta, Tabuchi, Motoyasu, Murokawa, Takahiro, Sakamoto, Shinichi, Iwata, Jun, Morita, Sojiro, Okamoto, Nobuto, Iiyama, Tatsuo, Shimada, Yasuhiro, Fujiwara, Toshiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698623/
https://www.ncbi.nlm.nih.gov/pubmed/36431269
http://dx.doi.org/10.3390/jcm11226792
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author Okabayashi, Takehiro
Sui, Kenta
Tabuchi, Motoyasu
Murokawa, Takahiro
Sakamoto, Shinichi
Iwata, Jun
Morita, Sojiro
Okamoto, Nobuto
Iiyama, Tatsuo
Shimada, Yasuhiro
Fujiwara, Toshiyoshi
author_facet Okabayashi, Takehiro
Sui, Kenta
Tabuchi, Motoyasu
Murokawa, Takahiro
Sakamoto, Shinichi
Iwata, Jun
Morita, Sojiro
Okamoto, Nobuto
Iiyama, Tatsuo
Shimada, Yasuhiro
Fujiwara, Toshiyoshi
author_sort Okabayashi, Takehiro
collection PubMed
description Survival remains poor even after resection of pancreatic cancer and the postoperative recurrence rate is extremely high. Thus, neoadjuvant treatment may improve outcomes for resectable pancreatic cancer (RPC). This study evaluated the efficacy of neoadjuvant therapy for radiologically judged RPC. A prospectively maintained institutional database was reviewed to identify patients who underwent potentially curative resection of radiologically judged RPC. Patient characteristics and intermediate-term outcomes were compared between groups that received neoadjuvant treatment or upfront surgery (UFS). We identified 353 eligible patients, including 55 patients who received neoadjuvant chemoradiotherapy (CRT group), 53 patients who received neoadjuvant gemcitabine plus nab-paclitaxel (GnP group), and 245 patients who underwent UFS (UFS group). The cumulative rates of pancreatic cancer recurrence at 2 years after pancreatic surgery were 49.5% in the UFS, 48.1% in the CRT group, and 52.7% in the GnP group. The recurrence rate tended to be improved after neoadjuvant treatment, although the difference was not significant at this follow-up point. While the clinical TNM classifications were noticeably different from the final pathological findings, the clinical and pathological TNM classifications were more similar in the groups that underwent neoadjuvant treatment. Neoadjuvant treatment can help identify good surgical candidates and avoid unnecessary laparotomy. Our results also suggest that neoadjuvant therapy might help improve the preoperative diagnostic accuracy for patients with RPC.
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spelling pubmed-96986232022-11-26 Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer Okabayashi, Takehiro Sui, Kenta Tabuchi, Motoyasu Murokawa, Takahiro Sakamoto, Shinichi Iwata, Jun Morita, Sojiro Okamoto, Nobuto Iiyama, Tatsuo Shimada, Yasuhiro Fujiwara, Toshiyoshi J Clin Med Article Survival remains poor even after resection of pancreatic cancer and the postoperative recurrence rate is extremely high. Thus, neoadjuvant treatment may improve outcomes for resectable pancreatic cancer (RPC). This study evaluated the efficacy of neoadjuvant therapy for radiologically judged RPC. A prospectively maintained institutional database was reviewed to identify patients who underwent potentially curative resection of radiologically judged RPC. Patient characteristics and intermediate-term outcomes were compared between groups that received neoadjuvant treatment or upfront surgery (UFS). We identified 353 eligible patients, including 55 patients who received neoadjuvant chemoradiotherapy (CRT group), 53 patients who received neoadjuvant gemcitabine plus nab-paclitaxel (GnP group), and 245 patients who underwent UFS (UFS group). The cumulative rates of pancreatic cancer recurrence at 2 years after pancreatic surgery were 49.5% in the UFS, 48.1% in the CRT group, and 52.7% in the GnP group. The recurrence rate tended to be improved after neoadjuvant treatment, although the difference was not significant at this follow-up point. While the clinical TNM classifications were noticeably different from the final pathological findings, the clinical and pathological TNM classifications were more similar in the groups that underwent neoadjuvant treatment. Neoadjuvant treatment can help identify good surgical candidates and avoid unnecessary laparotomy. Our results also suggest that neoadjuvant therapy might help improve the preoperative diagnostic accuracy for patients with RPC. MDPI 2022-11-16 /pmc/articles/PMC9698623/ /pubmed/36431269 http://dx.doi.org/10.3390/jcm11226792 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Okabayashi, Takehiro
Sui, Kenta
Tabuchi, Motoyasu
Murokawa, Takahiro
Sakamoto, Shinichi
Iwata, Jun
Morita, Sojiro
Okamoto, Nobuto
Iiyama, Tatsuo
Shimada, Yasuhiro
Fujiwara, Toshiyoshi
Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title_full Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title_fullStr Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title_full_unstemmed Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title_short Possibility of Neoadjuvant Treatment for Radiologically Judged Resectable Pancreatic Cancer
title_sort possibility of neoadjuvant treatment for radiologically judged resectable pancreatic cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698623/
https://www.ncbi.nlm.nih.gov/pubmed/36431269
http://dx.doi.org/10.3390/jcm11226792
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