title: Survival impact of neoadjuvant gemcitabine plus S-1 chemotherapy for patients with borderline resectable pancreatic carcinoma with arterial contact.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of neoadjuvant gemcitabine plus S-1 (GS) chemotherapy as measured by overall survival for patients with pancreatic carcinoma with arterial contact.
  
  
  METHODS
  Medical records of 77 patients with pancreatic carcinoma with arterial contact who intended to undergo tumor resection were analyzed retrospectively. These patients were divided into two groups: patients who underwent upfront surgery and patients who underwent tumor resection after neoadjuvant GS chemotherapy. Clinicopathological factors were compared between the two groups.
  
  
  RESULTS
  Of the 77 patients, 25 patients underwent upfront surgery while the remaining 52 patients received neoadjuvant GS chemotherapy. Seven patients did not undergo tumor resection due to distant metastasis. No serious adverse effects associated with neoadjuvant GS chemotherapy were observed. The R0 resection rate of patients who received neoadjuvant GS chemotherapy was significantly higher than that of patients who did not (P < 0.001). Overall survival of patients who received neoadjuvant GS chemotherapy was significantly longer than that of patients who did not among all 77 patients (P = 0.003, median survival time, 27.1 vs. 11.6 months) as well as among the 70 patients who underwent tumor resection (P = 0.001, median survival time, 27.2 vs. 11.6 months). Multivariate analysis demonstrated that neoadjuvant GS chemotherapy was an independent prognostic factor of overall survival for patients who underwent tumor resection (P = 0.019).
  
  
  CONCLUSIONS
  Neoadjuvant GS chemotherapy may provide a survival benefit to patients with pancreatic carcinoma with arterial contact.
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. mura777@hiroshima-u.ac.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sudo
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Naru
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakagawa
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects; D000093542:Gemcitabine
chemical_list: D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine
keywords: Arterial contact; Gemcitabine; Neoadjuvant chemotherapy; Pancreatic carcinoma; S-1