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Neoadjuvant/Downstaging Radiochemotherapy in Marginally Resectable Pancreatic Cancer

Ansari, Daniel LU ; Kervinen, Miikka and Andersson, Roland LU (2014) In Hepato-Gastroenterology 61(136). p.2387-2390
Abstract
Pancreatic cancer is a challenging disease due to the low resection rate at the time of initial diagnosis. A relatively new classification of marginally resectable pancreatic cancer has emerged and there is some evidence that this subgroup of patients may benefit from neoadjuvant radiochemotherapy. The first major definition of marginally resectable pancreatic cancer was made at M. D. Anderson Cancer Center and published in 2006. This definition was purely anatomical and CT-based and only handles the relationship of the pancreatic tumor to its surrounding major vessels. Later on, two other subtypes have been added to this definition: suspicion or known metastasis in regional lymph nodes (N1 disease), or severe pre-existing medical... (More)
Pancreatic cancer is a challenging disease due to the low resection rate at the time of initial diagnosis. A relatively new classification of marginally resectable pancreatic cancer has emerged and there is some evidence that this subgroup of patients may benefit from neoadjuvant radiochemotherapy. The first major definition of marginally resectable pancreatic cancer was made at M. D. Anderson Cancer Center and published in 2006. This definition was purely anatomical and CT-based and only handles the relationship of the pancreatic tumor to its surrounding major vessels. Later on, two other subtypes have been added to this definition: suspicion or known metastasis in regional lymph nodes (N1 disease), or severe pre-existing medical comorbidities requiring prolonged evaluation or recovery and precluding immediate surgery. Other definitions (anatomical and CT-based) for marginally resectable pancreatic cancer have also been established. For systematic research on neoadjuvant therapy in marginally resectable pancreatic cancer, however, the lack of uniform definitions and randomized trials have been troublesome. Nevertheless, several small cohort studies have demonstrated that 40-80% of the marginally resectable patients could proceed to resection after neoadjuvant treatment and also reporting some promising effects on microscopic resection margins, lymph node status and survival. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Pancreatic cancer, Marginally resectable tumor, Neoadjuvant therapy, Definition, Outcome, Cost-effectiveness
in
Hepato-Gastroenterology
volume
61
issue
136
pages
2387 - 2390
publisher
Georg Thieme Verlag
external identifiers
  • wos:000346326500048
  • scopus:84921775599
ISSN
0172-6390
DOI
10.5754/hge13404
language
English
LU publication?
yes
id
e76fb5f1-7802-449a-ac68-b43ed2a8f1ef (old id 4944777)
date added to LUP
2015-02-03 07:06:20
date last changed
2017-01-01 06:12:51
@article{e76fb5f1-7802-449a-ac68-b43ed2a8f1ef,
  abstract     = {Pancreatic cancer is a challenging disease due to the low resection rate at the time of initial diagnosis. A relatively new classification of marginally resectable pancreatic cancer has emerged and there is some evidence that this subgroup of patients may benefit from neoadjuvant radiochemotherapy. The first major definition of marginally resectable pancreatic cancer was made at M. D. Anderson Cancer Center and published in 2006. This definition was purely anatomical and CT-based and only handles the relationship of the pancreatic tumor to its surrounding major vessels. Later on, two other subtypes have been added to this definition: suspicion or known metastasis in regional lymph nodes (N1 disease), or severe pre-existing medical comorbidities requiring prolonged evaluation or recovery and precluding immediate surgery. Other definitions (anatomical and CT-based) for marginally resectable pancreatic cancer have also been established. For systematic research on neoadjuvant therapy in marginally resectable pancreatic cancer, however, the lack of uniform definitions and randomized trials have been troublesome. Nevertheless, several small cohort studies have demonstrated that 40-80% of the marginally resectable patients could proceed to resection after neoadjuvant treatment and also reporting some promising effects on microscopic resection margins, lymph node status and survival.},
  author       = {Ansari, Daniel and Kervinen, Miikka and Andersson, Roland},
  issn         = {0172-6390},
  keyword      = {Pancreatic cancer,Marginally resectable tumor,Neoadjuvant therapy,Definition,Outcome,Cost-effectiveness},
  language     = {eng},
  number       = {136},
  pages        = {2387--2390},
  publisher    = {Georg Thieme Verlag},
  series       = {Hepato-Gastroenterology},
  title        = {Neoadjuvant/Downstaging Radiochemotherapy in Marginally Resectable Pancreatic Cancer},
  url          = {http://dx.doi.org/10.5754/hge13404},
  volume       = {61},
  year         = {2014},
}