title: [The Safety and Feasibility of Conversion Surgery for Initially Unresectable Pancreatic Cancer].
abstract: BACKGROUND
  By remarkable progress of chemotherapy for pancreatic cancer, we sometimes achieve resection of initially unresectable pancreatic cancer after chemotherapy. Otherwise, the safety and feasibility of radical pancreatic resection after chemotherapy is not still clear. In this report, we evaluated the safety and feasibility of conversion surgery for initially unresectable pancreatic cancer in our center.
  
  
  METHODS
  Between 2009 and 2014, approximately 500 patients were diagnosed with unresectable pancreatic cancer and received chemotherapy, and after chemotherapy, 10 patients were found to have resectable tumors on computed tomography. We evaluated surgical complications using the Clavien-Dindo classification. Clinicopathological data were reviewed by using UICC, seventh edition, and the chemotherapeutic effect was measured by using Evans classification.
  
  
  RESULTS
  The mean age of patients was 68 years, with 4 men and 6 women. The preoperative chemotherapy regimens were S-1 chemotherapy in 2 patients, gemcitabine in 5 patients, and gemcitabine plus S-1 chemotherapy in 3 patients. Nine patients underwent pancreatoduodenectomy, and 1 underwent distal pancreatosplenectomy. The mean operative time was 527.5 minutes, and the mean estimated blood loss was 875 mL. Surgery-related morbidity more than Grade 2 based on Clavien-Dindo classification occurred in 6 patients. Mortality was 0%.
  
  
  CONCLUSIONS
  Our study suggests that conversion surgery for initially unresectable pancreatic cancer is safe and feasible.
authors.affiliation: Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Murakawa
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kazama
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Atsumi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamaoku
authors.forename: Amane
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Akio
authors.initials: A
authors.lastname: Higuchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Shiozawa
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Soichiro
authors.initials: S
authors.lastname: Morinaga
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents