title: Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System.
abstract: OBJECTIVE
  Previous reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer.
  
  
  METHODS
  93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used.
  
  
  RESULTS
  The overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312).
  
  
  CONCLUSIONS
  The coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.|Department of Radiology, Nara City Hospital, Nara, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Hashimoto
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan. toshihir@bf6.so-net.ne.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishiofuku
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Masada
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Marugami
authors.affiliation: Department of Radiology, Nara City Hospital, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Anai
authors.affiliation: Department of Radiology, Nara Prefectural Western Medical Center, Sango, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaguchi
authors.affiliation: Oncology Center, Nara Medical University, Kashihara, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kanno
authors.affiliation: Department of Radiation Oncology, Nara Medical University, Kashihara, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tamamoto
authors.affiliation: Department of Radiation Oncology, Nara Medical University, Kashihara, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Arterial infusion chemotherapy; Liver metastases; Pancreatic cancer