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Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer Using In-Situ No-Touch Isolation Technique
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[Multidisciplinary Therapy for Unresectable Pancreatic Cancer]
Taro Mashiko1, Akira Nakano, Yoshihito Masuoka
1Dept. of Gastroenterological Surgery, Tokai University School of Medicine.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|November 1, 2020
Summary
Conversion surgery may improve survival for unresectable pancreatic cancer (URPC) patients. Prolonging preoperative chemotherapy could better select candidates for conversion surgery, potentially enhancing long-term outcomes for URPC.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- First-line chemotherapy regimens like gemcitabine with nab-paclitaxel (GnP) and FOLFIRINOX have improved outcomes for unresectable pancreatic cancer (URPC).
- Conversion surgery (CS) is increasingly considered for URPC patients who respond to neoadjuvant therapy, potentially offering long-term survival.
Purpose of the Study:
- To evaluate the treatment outcomes of URPC patients in our department.
- To assess the feasibility and impact of conversion surgery (CS) adaptation for URPC.
Main Methods:
- Retrospective analysis of 36 URPC patients treated with GnP or FOLFIRINOX between 2015 and 2018.
- Comparison of outcomes between patients who underwent conversion surgery (CS) and those who did not.
Main Results:
- Conversion surgery (CS) was performed in 25% of patients (9/36).
- The 2-year survival rate was higher in the CS group (53.3%) compared to the non-CS group (34.1%), though not statistically significant (p=0.141).
- Early recurrence in some CS patients was linked to short preoperative chemotherapy duration and unnormalized tumor markers.
Conclusions:
- While conversion surgery (CS) shows a trend towards better prognosis in URPC, patient selection is critical.
- Prolonging neoadjuvant chemotherapy may improve the selection of suitable candidates for conversion surgery (CS), potentially leading to better long-term survival in URPC.
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