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Updated: Jul 4, 2026
Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
Preoperative Gemcitabine/Nab-Paclitaxel With Concurrent Radiation Therapy for Borderline Resectable Pancreatic
Hirofumi Akita1, Hidenori Takahashi1, Yousuke Mukai1
1Department of Gastroenterological Surgery The University of Osaka Suita City Osaka Japan.
Background:
Although NCCN guidelines recommend preoperative therapy for borderline resectable pancreatic cancer (BR-PC), it is still unclear which regimen is better. The study objective was to elucidate the prognostic significance of neoadjuvant chemoradiotherapy (NACRT) with gemcitabine/nab-paclitaxel (GnP-RT) compared to gemcitabine alone (Gem-RT) in BR-PC.
Methods:
Of 201 patients with BR-PC enrolled in the study, 102 were receiving GnP-RT and 99 were receiving Gem-RT. We evaluated clinical outcomes between these two groups, including CA19-9 values, rate of tumor reduction, overall (OS) and progression-free survival (PFS) rates, and distant and local recurrence.
Results:
CA19-9 values and tumor size reduction rate after NACRT were significantly higher with GnP-RT than with Gem-RT. With GnP-RT, the 5-year OS rate was 55.2% and the PFS rate was 42.1%, both significantly better than rates with Gem-RT (OS, 35.4%, p = 0.006; PFS, 31.9%, p = 0.041). The incidence of distant recurrence with GnP-RT was significantly lower than with Gem-RT (p = 0.018), but the incidence of local recurrence did not differ between the two groups (p = 0.905), indicating that the better survival with GnP-RT might arise from a systemic effect of enhanced chemotherapy.
Conclusion:
Enhanced chemotherapy may improve survival in patients with BR-PC by suppressing distant metastasis through a potent systemic antitumor effect.
