title: Short term chemotherapy followed by radiofrequency ablation in stage III pancreatic cancer: results from a single center.
abstract: BACKGROUND
  Neo-adjuvant chemotherapy (CHT) has gained increasing importance in resectable and borderline resectable pancreatic cancer leading to a better performing surgery when we look at negative resection margins and selection of patients with less aggressive disease. We apply this principle to patients with Stage III (LAC) pancreatic cancer undergoing RFA and try to select patients who may benefit from a local treatment.
  
  
  METHODS
  All patients affected by LAC were treated with RFA for a stable disease after a short CHT. Postoperative morbidity and mortality were evaluated together with overall survival (OS) and disease specific survival (DSS).
  
  
  RESULTS
  We consecutively treated 57 patients affected by LAC. Median duration of CHT before RFA was 5 months. The postoperative mortality rate was zero. Overall morbidity was 14 % with RFA-related morbidity of 3.5 %. The OS and DSS were 19 months and when compared to a similar population who received RFA as up front treatment, there was no difference.
  
  
  CONCLUSIONS
  Our results do not support the adoption of a short CHT as a way to identify patients to treat with RFA with the most benefit. Based on this and by knowing the role of immune modulation after RFA and its specific involvement in pancreatic carcinoma, we can propose RFA as upfront treatment.
authors.affiliation: Hepato-Pancreato-Biliary Unit, Casa di Cura Pederzoli, Via Monte Baldo 24, Peschiera del Garda, 37019, Verona, Italy; Department of Surgery B, Pancreas Institute, GB Rossi Hospital, University of Verona, Verona, Italy. isifrigerio@yahoo.com.
authors.forename: Isabella
authors.initials: I
authors.lastname: Frigerio
authors.forename: Roberto
authors.initials: R
authors.lastname: Girelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giardino
authors.forename: Paolo
authors.initials: P
authors.lastname: Regi
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: locally advanced pancreatic cancer; pancreatic tumor ablation; pre-operative chemotherapy