title: Treatment Strategy for Borderline Resectable Pancreatic Cancer With Radiographic Artery Involvement.
abstract: We evaluated whether neoadjuvant therapy followed by surgical resection improves the clinical outcome for patients with borderline resectable pancreatic cancer with radiologic artery involvement (BRPC-A).
  
  
  
  We reviewed 143 BRPC-A patients from among 330 pancreatic cancer patients, including 111 potentially resectable pancreatic cancer patients and 76 borderline resectable pancreatic cancer with portal/superior mesenteric vein involvement patients, who underwent surgery at Wakayama Medical University Hospital. We compared the clinicopathological factors of 40 BRPC-A patients treated with neoadjuvant therapy followed by surgery and those of 103 BRPC-A patients treated with upfront surgery.
  
  
  
  The R0 rate and progression-free survival of BRPC-A patients who received neoadjuvant therapy and subsequent surgical resection were significantly better compared to those who received upfront surgery (R0: P = 0.041; progression-free survival: P = 0.033), but overall survival was not significantly different. A multivariate analysis showed that intraoperative transfusion (P = 0.007), moderately or poorly differentiated pathological adenocarcinoma (P = 0.019), and failure to complete postoperative adjuvant therapy (P < 0.001) independently predicted a poor prognosis for BRPC-A patients who underwent surgical resection.
  
  
  
  Neoadjuvant treatment followed by surgery might provide clinical benefits for BRPC-A patients; however, the establishment of the most appropriate neoadjuvant therapy is needed by further studies.
authors.affiliation: From the Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Hirono
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Okada
authors.forename: Motoki
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimizu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kitahata
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D001158:Arteries; D006801:Humans; D020360:Neoadjuvant Therapy; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms; D012189:Retrospective Studies