title: Preoperative chemotherapy does not adversely affect pancreatic structure and short-term outcome after pancreatectomy.
abstract: BACKGROUND
  Preoperative chemotherapy (PCHT) has recently been proposed also in patients with resectable pancreatic adenocarcinoma. Few data are currently available on the impact of PCHT on short-term postoperative outcome after pancreatic resection. The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection.
  
  
  METHODS
  Fifty consecutive patients successfully underwent resection after PCHT. Each patient was matched with two control patients with pancreatic adenocarcinoma selected from our prospective electronic database. Match criteria were age (±3 years), gender, American Society of Anesthesiologist score, type of resection, pancreatic duct diameter (±1 mm), and tumor size (±5 mm). Primary endpoint was morbidity rate. Secondary endpoints were pancreatic parenchymal structure, mortality rate, and length of hospital stay (LOS).
  
  
  RESULTS
  Both degree of fibrosis and fatty infiltration of the pancreas were similar in the two groups. Overall morbidity rate was 48.0 % in the PCHT group vs. 54.0 % in the control group (p = 0.37). Pancreatic fistula rate was 18.0 % in the PCHT group vs. 25.0 % in the control group (p = 0.41). Mortality was 4.0 % in the PCHT group vs. 2.0 % in the control group (p = 0.60). Mean LOS (days) was 12.7 in the PCHT group vs. 12.4 in the control group (p = 0.74). There was no difference in resection margin status, while the rate of patients without nodal involvement was higher in the PCHT group (46.0 vs. 23.0 %, p = 0.004).
  
  
  CONCLUSIONS
  PCHT did not induce significant structural changes in pancreatic parenchyma and did not adversely affect short-term outcome after surgery.
authors.affiliation: Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pecorelli
authors.forename: Marco
authors.initials: M
authors.lastname: Braga
authors.forename: Claudio
authors.initials: C
authors.lastname: Doglioni
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Balzano
authors.forename: Michele
authors.initials: M
authors.lastname: Reni
authors.forename: Stefano
authors.initials: S
authors.lastname: Cereda
authors.forename: Luca
authors.initials: L
authors.lastname: Albarello
authors.forename: Renato
authors.initials: R
authors.lastname: Castoldi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Capretti
authors.forename: Valerio
authors.initials: V
authors.lastname: Di Carlo
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000273:Adipose Tissue; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005355:Fibrosis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010179:Pancreas / Q000187:drug effects / Q000473:pathology*; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000628:therapy*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000093542:Gemcitabine