title: [Efficacy of Neoadjuvant Therapy for Borderline Resectable Pancreatic Cancer Involving the Superior Mesenteric Artery].
abstract: Multidisciplinary therapy is essential in the treatment of borderline resectable pancreatic cancer involving the superior mesenteric artery (BR-SMA). We analyzed the outcomes of multidisciplinary treatment for BR-SMA and evaluated the efficacy of neoadjuvant therapy (NAT). We reviewed the clinical courses of 10 patients with BR-SMA. Seven patients were treated with preoperative neoadjuvant therapy (NAT group), and 3 patients underwent radical pancreaticoduodenectomy first (SF group). In the NAT group, the rate of R0 was 7/7 (100%), the induction rate of postoperative adjuvant chemotherapy (AC) was 6/7 (86%), and the first recurrence sites were the lung in 4 patients, and the liver and peritoneum in one patient each, respectively. In the SF group, the rate of R0 was 2/3 (67%) because of a positive pathological dissecting peripancreatic margin in 1 case. The induction rate of AC was 3/3 (100%), and the first recurrence sites were the liver in 2 patients, the peritoneum in 1, and a local site in 1. The disease free survival of the NAT group (median survival time [MST] 19.3 months) was significantly better than that of the SF group (MST 5.7 months) (log rank test, p=0.002). The median overall survival of the NAT and SF groups was 51.6 months and 19.5 months, respectively (p=0.128). An R0 resection could be performed in all cases in the NAT group. The NAT extended disease-free survival. We conclude that NAT is recommended in the treatment of BR-SMA.
authors.affiliation: Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsukawa
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Shiozaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Satoh
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Araki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Idani
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Ojima
authors.forename: Masao
authors.initials: M
authors.lastname: Harano
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tokumoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Choda
authors.forename: Michihiro
authors.initials: M
authors.lastname: Ishida
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Masazumi
authors.initials: M
authors.lastname: Okajima
authors.forename: Motoki
authors.initials: M
authors.lastname: Ninomiya
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000473:pathology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents