title: Neoadjuvant strategy as initial treatment in resectable pancreatic cancer: concrete evidence of benefit.
abstract: Pancreatoduodenectomy remains the recommended treatment in potentially curative strategies for pancreatic carcinoma. Due to high local failure rates even after complete resection, a multi-modality treatment approach is paramount in the management of resectable disease. Despite there being insufficient evidence to recommend a specific neoadjuvant strategy, several studies have tested the use of preoperative chemoradiotherapy in this sub-group of patients, achieving promising results. The treatment is well-tolerated, with higher rates of negative margins and lower rates of lymph node positivity at resection, a decrease in local failure and benefit in overall survival. Considering the poor oncological results after primary surgical treatment, neoadjuvant strategy should be considered as a valid alternative in resectable pancreatic carcinoma.
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy fradefelice@hotmail.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: DE Felice
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Musio
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Raffetto
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy Spencer-Lorillard Foundation, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D059248:Chemoradiotherapy; D019317:Evidence-Based Medicine; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome
keywords: Pancreas; neoadjuvant treatment; pancreatic cancer; review