Aggressive surgery for borderline resectable pancreatic cancer: Evaluation of national comprehensive cancer network guidelines

Suguru Yamada, Tsutomu Fujii*, Hiroyuki Sugimoto, Shuji Nomoto, Shin Takeda, Yasuhiro Kodera, Akimasa Nakao

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

91 被引用数 (Scopus)

抄録

OBJECTIVES: The objective of this study was to evaluate the relevance of defining borderline resectable (BR) pancreatic cancer as a distinct entity in the treatment scheme of pancreatic cancer as proposed by the National Comprehensive Cancer Network. METHODS: Among 375 patients with pancreatic cancer, 137 patients were deemed to have resectable disease (R) by preoperative imaging studies, whereas 96 were found to have an unresectable disease during surgery. The remaining 142 patients fulfilled the definition of BR and were further classified into 3 subgroups based on the National Comprehensive Cancer Network guidelines: portal vein invasion (PV[+]), common hepatic artery invasion (CHA[+]), and superior mesenteric artery invasion (SMA[+]). PV(+) was subdivided into types B, C, and D according to the degree of portal vein invasion. RESULTS: Patients in the R group had significantly better survival than those in the PV(+) group (P = 0.0038), who in turn survived significantly longer than those classified as SMA(+) (P = 0.041). Type B patients survived significantly longer than did types C and D patients (P = 0.013 and P = 0.030, respectively). In PV(+) patients, compliance with postoperative chemotherapy at 3 and 6 months was 56.9% and 44.6%, respectively, substantially inferior to patients with resectable disease (72.6% and 54.7%, respectively). CONCLUSIONS: The optimal treatment strategy may differ among various subgroups within the BR category.

本文言語英語
ページ(範囲)1004-1010
ページ数7
ジャーナルPancreas
42
6
DOI
出版ステータス出版済み - 2013/08

ASJC Scopus 主題領域

  • 内科学
  • 内分泌学、糖尿病および代謝内科学
  • 肝臓学
  • 内分泌学

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