Survival impact of neoadjuvant gemcitabine plus S-1 chemotherapy for patients with borderline resectable pancreatic carcinoma with arterial contact

Murakami, Yoshiaki; Uemura, Kenichiro; Sudo, Takeshi; Hashimoto, Yasushi; Kondo, Naru; Nakagawa, Noritoshi; Takahashi, Shinya; Sueda, Taijiro

doi:10.1007/s00280-016-3199-z

Cited by 51 publications

(44 citation statements)

References 22 publications

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“…The weighted median overall survival of 819 patients with resectable pancreatic cancer was 17·7 (12–25·3) months, compared with 12·8 (11·6–16·3) months for 927 patients with borderline resectable pancreatic cancer ( Figs and ). In the largest (retrospective) study of Kato and colleagues, 63 of 624 patients (10·1 per cent) with borderline resectable pancreatic cancer also received neoadjuvant treatment and the median overall survival of these patients was not available separately.…”

Section: Resultsmentioning

confidence: 96%

“…The R0 resection rate was reported in 11 studies after upfront surgery and was 66·9 (95 per cent c.i. 64·2 to 69·6) (range 17–81) per cent.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies reported the median overall survival of 1746 patients undergoing upfront surgery for resectable or borderline resectable pancreatic cancer by intention to treat ( Figs and ). Overall, 81·3 per cent of 1746 patients underwent resection, with an overall weighted median overall survival of 14·8 (range 11·6–25·3) months.…”

Section: Resultsmentioning

confidence: 99%

“…In the largest (retrospective) study of Kato and colleagues, 63 of 624 patients (10·1 per cent) with borderline resectable pancreatic cancer also received neoadjuvant treatment and the median overall survival of these patients was not available separately. The outcome of the subgroup of patients who actually underwent resection was reported in seven of 12 studies; the weighted median overall survival was 15·0 months for these 1048 patients (not by intention to treat).…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer

Versteijne¹,

Vogel

Besselink

et al. 2018

British Journal of Surgery

417

354

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BackgroundStudies comparing upfront surgery with neoadjuvant treatment in pancreatic cancer may report only patients who underwent resection and so survival will be skewed. The aim of this study was to report survival by intention to treat in a comparison of upfront surgery versus neoadjuvant treatment in resectable or borderline resectable pancreatic cancer.MethodsMEDLINE, Embase and the Cochrane Library were searched for studies reporting median overall survival by intention to treat in patients with resectable or borderline resectable pancreatic cancer treated with or without neoadjuvant treatment. Secondary outcomes included overall and R0 resection rate, pathological lymph node rate, reasons for unresectability and toxicity of neoadjuvant treatment.ResultsIn total, 38 studies were included with 3484 patients, of whom 1738 (49·9 per cent) had neoadjuvant treatment. The weighted median overall survival by intention to treat was 18·8 months for neoadjuvant treatment and 14·8 months for upfront surgery; the difference was larger among patients whose tumours were resected (26·1 versus 15·0 months respectively). The overall resection rate was lower with neoadjuvant treatment than with upfront surgery (66·0 versus 81·3 per cent; P < 0·001), but the R0 rate was higher (86·8 (95 per cent c.i. 84·6 to 88·7) versus 66·9 (64·2 to 69·6) per cent; P < 0·001). Reported by intention to treat, the R0 rates were 58·0 and 54·9 per cent respectively (P = 0·088). The pathological lymph node rate was 43·8 per cent after neoadjuvant therapy and 64·8 per cent in the upfront surgery group (P < 0·001). Toxicity of at least grade III was reported in up to 64 per cent of the patients.ConclusionNeoadjuvant treatment appears to improve overall survival by intention to treat, despite lower overall resection rates for resectable or borderline resectable pancreatic cancer.PROSPERO registration number: CRD42016049374.

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Section: Resultsmentioning

confidence: 96%

“…The R0 resection rate was reported in 11 studies after upfront surgery and was 66·9 (95 per cent c.i. 64·2 to 69·6) (range 17–81) per cent.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer

Versteijne¹,

Vogel

Besselink

et al. 2018

British Journal of Surgery

417

354

View full text Add to dashboard Cite

show abstract

“…However, with rapid developments in chemotherapeutic regimens, both adjuvant chemotherapy and neoadjuvant chemo(radio)therapy (NAC(RT)) have been shown to be beneficial for patients with borderline resectable pancreatic cancer [3] or advanced biliary tract cancer [4]. While gemcitabine plus tegafur/gimeracil/oteracil (GS) as NAC(RT) has been reported to be safe and effective for patients with borderline resectable pancreatic cancer [5], GS as adjuvant chemotherapy [6] and gemcitabine as NAC [7] have been reported to be safe and effective for patients with advanced biliary tract cancer.…”

Section: Introductionmentioning

confidence: 99%

The maximum chemiluminescence intensity predicts severe neutropenia in gemcitabine-treated patients with pancreatic or biliary tract cancer

Goto

Matsuyama

Suwa

et al. 2018

Cancer Chemother Pharmacol

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Essential updates 2018/2019: Current topics in the surgical treatment of pancreatic ductal adenocarcinoma

Ishido

Hakamada

Kimura

et al. 2020

Annals of Gastroent Surgery

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Pancreatic ductal adenocarcinoma (PDAC) is highly malignant. While cancers in other organs have shown clear improvements in 5‐year survival, the 5‐year survival rate of pancreatic cancer is approximately 10%. Early relapse and metastasis are not uncommon, making it difficult to achieve an acceptable prognosis even after complete surgical resection of the pancreas. Studies have been performed on various treatments to improve the prognosis of PDAC, and multidisciplinary approaches including non‐surgical treatments have led to gradual improvement. In the present literature review, we have described the significance of anatomical and biological resectability criteria, the concept of R0 resection in surgical treatment, the feasibility of minimally invasive surgery, the remarkable development of perioperative chemotherapy, the effectiveness of conversion surgery for unresectable PDAC, and ongoing challenges in PDAC treatment. We also provide an essential update on these subjects by focusing on recent trends and topics.

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Survival impact of neoadjuvant gemcitabine plus S-1 chemotherapy for patients with borderline resectable pancreatic carcinoma with arterial contact

Abstract: Neoadjuvant GS chemotherapy may provide a survival benefit to patients with pancreatic carcinoma with arterial contact.

Cited by 51 publications

References 22 publications

Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer

Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer

The maximum chemiluminescence intensity predicts severe neutropenia in gemcitabine-treated patients with pancreatic or biliary tract cancer

Essential updates 2018/2019: Current topics in the surgical treatment of pancreatic ductal adenocarcinoma

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