Does Prior Adjuvant Chemoradiotherapy Lead to a Safer Pancreatoduodenectomy?

Excerpt

The article by Cheng et al.1 is another attempt to compare the effects of preoperative versus postoperative adjuvant chemoradiotherapy (CRT) for presumably localized pancreatic adenocarcinoma by retrospective analysis of two nonrandomized treatment cohorts.2‐4 Because the only significant differences in morbidity within the preoperative and postoperative cohorts in this study were in pancreatic leak and intra-abdominal abscess formation (favoring the preoperative CRT cohort), the primary focus of this study was the relative incidence of postoperative pancreatic leaks. The authors aver that preoperative CRT reduces the incidence of both pancreatic leaks and leak-associated morbidity and mortality, and they even go so far as to recommend preoperative CRT in those with ampullary cancer to decrease postoperative leaks. …