title: Does pre-operative chemoradiation for initially unresectable or borderline resectable pancreatic adenocarcinoma increase post-operative morbidity? A case-matched analysis.
abstract: BACKGROUND
  Neoadjuvant chemoradiation therapy for locally unresectable and borderline resectable pancreatic cancer may allow some patients to a undergo a resection, but whether or not this increases post-operative morbidity remains unclear.
  
  
  METHODS
  The post-operative morbidity of 29 patients with initially locally unresectable/borderline pancreatic cancer who underwent a resection were compared with 29 patients with initially resectable tumours matched for age, gender, the presence of comorbidities (yes/no), American Society of Anesthesiology (ASA) score, tumour location (head/body-tail), procedure (pancreaticoduodenectomy/distal pancreatectomy) and vascular resection (yes /no). Wilcoxon's signed ranks test was used for continuous variables and McNemar's chi-square test for categorical variables.
  
  
  RESULTS
  Compared with patients with initially resectable tumours, patients who underwent a resection after pre-operative chemoradiation therapy had similar rates of overall post-operative complications (55% versus 41%, P = 0.42), major complications (21% versus 21%, P = 1), pancreatic leaks and fistulae (7% versus 10%, P = 1) and mortality (0% versus 1.7%, P = 1).
  
  
  CONCLUSIONS
  Although some previous studies have suggested differences in post-operative morbidity after chemoradiation, our case-matched analysis did not find statistical differences in surgical morbidity and mortality associated with pre-operative chemoradiation therapy.
authors: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors: Raphael L C
authors: RL
authors: Araujo
authors: Sébastien
authors: S
authors: Gaujoux
authors: Florence
authors: F
authors: Huguet
authors: Mithat
authors: M
authors: Gonen
authors: Michael I
authors: MI
authors: D'Angelica
authors: Ronald P
authors: RP
authors: DeMatteo
authors: Yuman
authors: Y
authors: Fong
authors: T Peter
authors: TP
authors: Kingham
authors: William R
authors: WR
authors: Jarnagin
authors: Karyn A
authors: KA
authors: Goodman
authors: Peter J
authors: PJ
authors: Allen
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000368:Aged; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects* / Q000401:mortality; D010180:Pancreatectomy / Q000009:adverse effects* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome