Postoperative Radiotherapy for Pancreatic Cancer with Microscopically-positive Resection Margin.
To analyze the outcomes in pancreatic cancer (PC) cases with a microscopically-positive resection margin (R1 resection) treated with postoperative radiotherapy (PORT).



We retrospectively analyzed the outcomes in 62 patients who received PORT for PC with R1 resection between 2001 and 2012. All patients received three-dimensional conformal radiotherapy. Concurrent chemotherapy was administered to 58 patients.



The median follow-up was 20.1 months. The median survival was 22.0 months and the 3-year overall survival rate was 25%. The 3-year disease-free survival and local recurrence-free survival rates were 12% and 54%, respectively. Local recurrence occurred in 23 patients (44%), distant failure in 45 (87%), and both in 16 (31%). By multivariate analysis, the postoperative cancer antigen 19-9 (CA19-9) level and adjuvant chemotherapy were independent prognostic factors for survival.



PORT is associated with a relatively favorable survival outcome in PC with R1 resection. Chemotherapy and postoperative CA19-9 level were significant prognostic factors for survival.
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sunmin
S
Park
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Song Cheol
SC
Kim
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Seung-Mo
SM
Hong
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Young-Joo
YJ
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Kwang-Min
KM
Park
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Dae Wook
DW
Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Jae Hoon
JH
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Ki-Byung
KB
Song
Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Baek-Yeol
BY
Ryoo
Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Heung-Moon
HM
Jang
Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Kyu-Pyo
KP
Kim
Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Changhoon
C
Yu
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Eun Kyung
EK
Choi
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Seung
S
DO Ahn
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sang-Wook
SW
Lee
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sang Min
SM
Yoon
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea jpark@amc.seoul.kr.
Jin-Hong
JH
Park
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Jong Hoon
JH
Kim
D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000032:analysis; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000072662:Margins of Excision; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D011184:Postoperative Period; D011247:Pregnancy; D011379:Prognosis; D016016:Proportional Hazards Models; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies
D018395:CA-19-9 Antigen
Pancreatic cancer; R1 resection; adjuvant radiotherapy