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Surgery Today
Published in: Surgery Today 5/2020

01-05-2020 | Pancreatoduodenostomy | Original Article

Clinical impact of additional therapy for residual pancreatic cancer

Authors: Suguru Yamada, Fuminori Sonohara, Mitsuru Tashiro, Kenta Murotani, Hideki Takami, Masamichi Hayashi, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Goro Nakayama, Masahiko Koike, Tsutomu Fujii, Yasuhiro Kodera

Published in: Surgery Today | Issue 5/2020

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Abstract

Purpose

This study aimed to explore the prognostic significance of the resection margin (R) status of pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant therapy (NAT) or adjuvant chemotherapy (AC).

Methods

We retrospectively reviewed 427 consecutive patients, and the overall survival (OS) and disease-free survival (DFS) were analyzed based on the R status by a propensity score analysis (PSA).

Results

The R0 ratio of the NAT (+) group was significantly higher than that of the NAT (−) group (97.2% vs. 69.6%, P < 0.0001). Local recurrence was well controlled in the NAT (+) group compared to the NAT (−) group (15.3% vs. 34.1%, P = 0.0013). The PSA revealed no significant survival difference between R0 and R1 resection among those treated with AC (median survival time [MST]: 43.0 vs. 33.3 months, matching hazard ratio [HR]: 1.212, P = 0.5708). Furthermore, the DFS in R0 and R1 resection followed by AC was identical (MST: 20.6 vs. 17.7 months, matching HR: 1.020, P = 0.9482).

Conclusions

NAT was a significant predictor of R0 resection. When patients completed AC, there were no marked differences in the OS or DFS between R0 and R1 resection. Our results demonstrated that the clinical impact of the R1 status has waned in the current era of PDAC management.
Appendix
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Metadata
Title
Clinical impact of additional therapy for residual pancreatic cancer
Authors
Suguru Yamada
Fuminori Sonohara
Mitsuru Tashiro
Kenta Murotani
Hideki Takami
Masamichi Hayashi
Mitsuro Kanda
Chie Tanaka
Daisuke Kobayashi
Goro Nakayama
Masahiko Koike
Tsutomu Fujii
Yasuhiro Kodera
Publication date
01-05-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 5/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01900-y

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