title: Chemoradiation followed by chemotherapy before resection for borderline pancreatic adenocarcinoma.
abstract: BACKGROUND
  For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival.
  
  
  METHODS
  A retrospective review of patients with borderline resectable pancreatic cancer treated with preoperative chemoradiation and standalone chemotherapy was undertaken. Clinical variables, including disease-free and overall survival, were collected. Univariate analysis was used to identify factors impacting survival.
  
  
  RESULTS
  Thirteen patients with borderline resectable pancreatic cancer were treated with preoperative chemoradiation and chemotherapy. Morbidity and mortality were 38% and 0. There were 2 R1 and 11 R0 resections. Nine patients are alive with a median follow-up of 20 months. Five patients recurred at a median of 4 months. Tumor fibrosis < or = 60% was associated with recurrence and poor survival.
  
  
  CONCLUSIONS
  Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival.
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Ave Philadelphia, PA 19027, USA.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Brown
authors.forename: Veeriah
authors.initials: V
authors.lastname: Siripurapu
authors.forename: Marson
authors.initials: M
authors.lastname: Davidson
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Cohen
authors.forename: Andre
authors.initials: A
authors.lastname: Konski
authors.forename: James C
authors.initials: JC
authors.lastname: Watson
authors.forename: Tiaynu
authors.initials: T
authors.lastname: Li
authors.forename: Vince
authors.initials: V
authors.lastname: Ciocca
authors.forename: Harry
authors.initials: H
authors.lastname: Cooper
authors.forename: John P
authors.initials: JP
authors.lastname: Hoffman
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016577:Pancreaticoduodenectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents