Borderline Resectable Pancreatic Cancer

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dc.contributor.author Katz, Matthew
dc.contributor.author Pisters, Peter
dc.contributor.author Evans, Douglas
dc.contributor.author Sun, Charlotte
dc.contributor.author Lee, Jeffrey
dc.contributor.author Fleming, Jason
dc.contributor.author Vauthey, Jean-Nicolas
dc.contributor.author Abdalla, Eddie
dc.contributor.author Crane, Christopher
dc.date.accessioned 2015-11-17T07:36:42Z
dc.date.available 2015-11-17T07:36:42Z
dc.date.copyright 2008
dc.date.issued 2015-11-17
dc.identifier.issn 1072-7515 en_US
dc.identifier.uri http://hdl.handle.net/10725/2589
dc.description.abstract Background Patients with borderline resectable pancreatic adenocarcinoma (PA) include those with localized disease who have tumor or patient characteristics that preclude immediate surgery. There is no optimal treatment schema for this distinct stage of disease, so the role of surgery is undefined. Study Design We defined patients with borderline resectable PA as fitting into one of three distinct groups. Group A comprised patients with tumor abutment of the visceral arteries or short-segment occlusion of the Superior Mesenteric Vein. In group B, patients had findings suggestive but not diagnostic of metastasis. Group C patients were of marginal performance status. Patients were treated initially with chemotherapy, chemoradiation, or both; those of sufficient performance status who completed preoperative therapy without disease progression were considered for surgery. Results Between October 1999 and August 2006, 160 (7%) of 2,454 patients with PA were classified as borderline resectable. Of these, 125 (78%) completed preoperative therapy and restaging, and 66 (41%) underwent pancreatectomy. Vascular resection was required in 18 (27%) of 66 patients, and 62 (94%) underwent a margin-negative pancreatectomy. A partial pathologic response to induction therapy (< 50% viable tumor) was seen in 37 (56%) of 66 patients. Median survival was 40 months for the 66 patients who completed all therapy and 13 months for the 94 patients who did not undergo pancreatectomy (p < 0.001). Conclusions This is the first large report of borderline resectable PA and includes objective definitions for this stage of disease. Our neoadjuvant approach allowed for identification of the marked subset of patients that was most likely to benefit from surgery, as evidenced by the favorable median survival in this group. en_US
dc.language.iso en en_US
dc.title Borderline Resectable Pancreatic Cancer en_US
dc.type Article en_US
dc.description.version N/A en_US
dc.title.subtitle The Importance of This Emerging Stage of Disease en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of the American College of Surgeons en_US
dc.journal.volume 206 en_US
dc.journal.issue 5 en_US
dc.article.pages 833-846 en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.jamcollsurg.2007.12.020 en_US
dc.identifier.ctation Katz, M. H., Pisters, P. W., Evans, D. B., Sun, C. C., Lee, J. E., Fleming, J. B., ... & Hwang, R. F. (2008). Borderline resectable pancreatic cancer: the importance of this emerging stage of disease. Journal of the American College of Surgeons, 206(5), 833-846. en_US
dc.author.email eddie.abdalla@lau.edu.lb

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