title: Influence of preoperative anti-cancer therapy on resectability and perioperative outcomes in patients with pancreatic cancer: project study by the Japanese Society of Hepato-Biliary-Pancreatic Surgery.
abstract: BACKGROUND
  Little is known about the effects of neoadjuvant therapy on outcomes in patients with pancreatic cancer. This study evaluated the effects of neoadjuvant therapy on resectability and perioperative outcomes.
  
  
  METHODS
  A total of 992 patients were enrolled, with 971 deemed eligible. Of these, 582 had resectable tumors and 389 had borderline resectable tumors, and 388 patients received neoadjuvant therapy. Demographic characteristics and peri- and postoperative parameters were assessed by a questionnaire survey.
  
  
  RESULTS
  The R0 rate was significantly higher in patients with resectable tumors who received neoadjuvant therapy than in those who underwent surgery first, but no significant difference was noted in patients with borderline resectable tumors. Operation time was significantly longer and blood loss was significantly greater in patients who received neoadjuvant therapy than in those who underwent surgery first, but there were no significant differences in specific complications and mortality rates. The node positivity rate was significantly lower in the neoadjuvant than in the surgery-first group, indicating that the former had significantly lower stage tumors.
  
  
  CONCLUSIONS
  Neoadjuvant therapy may not increase the mortality and morbidity rate and may be able to increase the chance for curative resection against resectable tumor.
authors.affiliation: Division of Gastroenterological Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Takaho
authors.initials: T
authors.lastname: Okada
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Sohei
authors.initials: S
authors.lastname: Satoi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Masashi
authors.initials: M
authors.lastname: Kishiwada
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
authors.forename: Hisafumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.forename: Shoichi
authors.initials: S
authors.lastname: Hishinuma
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kosuge
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D013502:General Surgery; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011300:Preoperative Care; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Neoadjuvant; Pancreatic cancer; Perioperative outcome; Resectability; Surgery