Locoregional chemotherapy for patients with pancreatic cancer intra-arterial adjuvant chemotherapy after pancreatectomy with portal vein resection.
OBJECTIVE
The survival of pancreatic cancer patients with portal vein resection is extremely poor due to the high incidence of liver metastasis. The occurrence of liver metastasis is decreased by locoregional arterial infusion after pancreatic surgery. Chemosensitivity tests can provide the basis for individualized chemotherapy in each patient and predict the clinical response. Therefore, the current study was designed to clarify whether locoregional chemotherapy based on the results of chemosensitivity tests has the clinical effects of preventing liver metastasis and improving survival for patients with portal vein resection.


METHODS
The resected specimens from 40 of 47 patients with resection of pancreatic cancer were assessed for chemosensitivity to various anticancer drugs. Fourteen patients underwent portal vein resection due to direct invasion, and nine of these patients received intra-arterial adjuvant chemotherapy on the basis of the results of MTT assay to prevent liver metastasis. The remaining five patients received no chemotherapy.


RESULTS
None of the patients who received intra-arterial chemotherapy had liver metastasis, and this group of patients had improved survival. The mean survival of patients with intra-arterial chemotherapy was significantly longer than that of patients without chemotherapy (25.6 months with chemotherapy versus 9.4 months without chemotherapy).


CONCLUSIONS
A pilot study of postoperative intra-arterial chemotherapy showed the reduction of liver metastasis and improvement of survival among pancreatic cancer patients with portal vein resection.
Yamaue
Hiroki
H
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan. yamaue-h@wakayama-med.ac.jp
Tani
Masaji
M
Onishi
Hironobu
H
Kinoshita
Hiroyuki
H
Nakamori
Mikihito
M
Yokoyama
Shozo
S
Iwahashi
Makoto
M
Uchiyama
Kazuhisa
K
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D004396:Coloring Agents / Q000737:chemistry; D004354:Drug Screening Assays, Antitumor / Q000379:methods*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D010865:Pilot Projects; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D013778:Tetrazolium Salts / Q000737:chemistry; D013844:Thiazoles / Q000737:chemistry; D014407:Tumor Cells, Cultured
D000970:Antineoplastic Agents; D004396:Coloring Agents; D013778:Tetrazolium Salts; D013844:Thiazoles; C022616:thiazolyl blue