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Efficacy of Neoadjuvant Chemotherapy in Distal Pancreatectomy with En Bloc Celiac Axis Resection (DP-CAR) for Locally Advanced Pancreatic Cancer
- Source :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 24(7)
- Publication Year :
- 2019
-
Abstract
- Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) is an extended surgical procedure for patients with locally advanced cancer of the pancreatic body and tail. Recently, the usability of neoadjuvant chemotherapy (NAC) in pancreatic cancer was reported. The purpose of this study was to clarify the impact of NAC on surgical outcomes and prognosis in DP-CAR patients. This study retrospectively reviewed 20 consecutive patients who underwent DP-CAR at a single institution. Eleven of 20 patients (55.0%) received NAC. Their first regimens were gemcitabine (GEM) plus nab-PTX (n = 7, 63.6%), GEM plus S-1 (n = 3, 27.3%), and GEM (n = 1, 9.1%). Although two patients converted to a second regimen, none abandoned NAC due to adverse effects or could not undergo a planned procedure for disease progression. There were no significant differences in intraoperative variables, morbidity, including pancreatic fistula and delayed gastric emptying, and mortality between patients with and without NAC; however, patients with NAC had a significantly lower proportion of arterial invasion (p = 0.025), lymphatic invasion (p
- Subjects :
- medicine.medical_specialty
Lymphovascular invasion
medicine.medical_treatment
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Pancreatectomy
Celiac Artery
Internal medicine
Pancreatic cancer
medicine
Humans
Adverse effect
Retrospective Studies
Chemotherapy
Gastric emptying
business.industry
medicine.disease
Gemcitabine
Neoadjuvant Therapy
Pancreatic Neoplasms
Regimen
Pancreatic fistula
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Surgery
business
medicine.drug
Subjects
Details
- ISSN :
- 18734626
- Volume :
- 24
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Accession number :
- edsair.doi.dedup.....c61e6e2494721e7c8a173d47c9b466ea