Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery

Sohei Satoi, Hiroki Yamaue, Kentaro Kato, Shinichiro Takahashi, Seiko Hirono, Shin Takeda, Hidetoshi Eguchi, Masayuki Sho, Keita Wada, Hiroyuki Shinchi, A. Hon Kwon, Satoshi Hirano, Taira Kinoshita, Akimasa Nakao, Hiroaki Nagano, Yoshiyuki Nakajima, Keiji Sano, Masaru Miyazaki, Tadahiro Takada

Research output: Contribution to journalArticle

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Abstract

Purpose: A multicenter survey was conducted to explore the role of adjuvant surgery for initially unresectable pancreatic cancer with a long-term favorable response to non-surgical cancer treatments. Methods: Clinical data including overall survival were retrospectively compared between 58 initially unresectable pancreatic cancer patients who underwent adjuvant surgery with a favorable response to non-surgical cancer treatments over 6 months after the initial treatment and 101 patients who did not undergo adjuvant surgery because of either unchanged unresectability, a poor performance status, and/or the patients' or surgeons' wishes. Results: Overall mortality and morbidity were 1.7 and 47 % in the adjuvant surgery group. The survival curve in the adjuvant surgery group was significantly better than in the control group (p < 0.0001). The propensity score analysis revealed that adjuvant surgery was a significant independent prognostic variable with an adjusted hazard ratio (95 % confidence interval) of 0.569 (0.36-0.89). Subgroup analysis according to the time from initial treatment to surgical resection showed a significant favorable difference in the overall survival in patients who underwent adjuvant surgery over 240 days after the initial treatment. Conclusion: Adjuvant surgery for initially unresectable pancreatic cancer patients can be a safe and effective treatment. The overall survival rate from the initial treatment is extremely high, especially in patients who received non-surgical anti-cancer treatment for more than 240 days.

Original languageEnglish
Pages (from-to)590-600
Number of pages11
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume20
Issue number6
DOIs
Publication statusPublished - Aug 1 2013

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Pancreatic Neoplasms
Neoplasms
Therapeutics
Survival
Propensity Score
Survival Rate
Confidence Intervals
Morbidity
Control Groups
Mortality

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments : Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. / Satoi, Sohei; Yamaue, Hiroki; Kato, Kentaro; Takahashi, Shinichiro; Hirono, Seiko; Takeda, Shin; Eguchi, Hidetoshi; Sho, Masayuki; Wada, Keita; Shinchi, Hiroyuki; Kwon, A. Hon; Hirano, Satoshi; Kinoshita, Taira; Nakao, Akimasa; Nagano, Hiroaki; Nakajima, Yoshiyuki; Sano, Keiji; Miyazaki, Masaru; Takada, Tadahiro.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 20, No. 6, 01.08.2013, p. 590-600.

Research output: Contribution to journalArticle

Satoi, S, Yamaue, H, Kato, K, Takahashi, S, Hirono, S, Takeda, S, Eguchi, H, Sho, M, Wada, K, Shinchi, H, Kwon, AH, Hirano, S, Kinoshita, T, Nakao, A, Nagano, H, Nakajima, Y, Sano, K, Miyazaki, M & Takada, T 2013, 'Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments: Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 20, no. 6, pp. 590-600. https://doi.org/10.1007/s00534-013-0616-0
Satoi, Sohei ; Yamaue, Hiroki ; Kato, Kentaro ; Takahashi, Shinichiro ; Hirono, Seiko ; Takeda, Shin ; Eguchi, Hidetoshi ; Sho, Masayuki ; Wada, Keita ; Shinchi, Hiroyuki ; Kwon, A. Hon ; Hirano, Satoshi ; Kinoshita, Taira ; Nakao, Akimasa ; Nagano, Hiroaki ; Nakajima, Yoshiyuki ; Sano, Keiji ; Miyazaki, Masaru ; Takada, Tadahiro. / Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments : Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2013 ; Vol. 20, No. 6. pp. 590-600.
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abstract = "Purpose: A multicenter survey was conducted to explore the role of adjuvant surgery for initially unresectable pancreatic cancer with a long-term favorable response to non-surgical cancer treatments. Methods: Clinical data including overall survival were retrospectively compared between 58 initially unresectable pancreatic cancer patients who underwent adjuvant surgery with a favorable response to non-surgical cancer treatments over 6 months after the initial treatment and 101 patients who did not undergo adjuvant surgery because of either unchanged unresectability, a poor performance status, and/or the patients' or surgeons' wishes. Results: Overall mortality and morbidity were 1.7 and 47 {\%} in the adjuvant surgery group. The survival curve in the adjuvant surgery group was significantly better than in the control group (p < 0.0001). The propensity score analysis revealed that adjuvant surgery was a significant independent prognostic variable with an adjusted hazard ratio (95 {\%} confidence interval) of 0.569 (0.36-0.89). Subgroup analysis according to the time from initial treatment to surgical resection showed a significant favorable difference in the overall survival in patients who underwent adjuvant surgery over 240 days after the initial treatment. Conclusion: Adjuvant surgery for initially unresectable pancreatic cancer patients can be a safe and effective treatment. The overall survival rate from the initial treatment is extremely high, especially in patients who received non-surgical anti-cancer treatment for more than 240 days.",
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T1 - Role of adjuvant surgery for patients with initially unresectable pancreatic cancer with a long-term favorable response to non-surgical anti-cancer treatments

T2 - Results of a project study for pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery

AU - Satoi, Sohei

AU - Yamaue, Hiroki

AU - Kato, Kentaro

AU - Takahashi, Shinichiro

AU - Hirono, Seiko

AU - Takeda, Shin

AU - Eguchi, Hidetoshi

AU - Sho, Masayuki

AU - Wada, Keita

AU - Shinchi, Hiroyuki

AU - Kwon, A. Hon

AU - Hirano, Satoshi

AU - Kinoshita, Taira

AU - Nakao, Akimasa

AU - Nagano, Hiroaki

AU - Nakajima, Yoshiyuki

AU - Sano, Keiji

AU - Miyazaki, Masaru

AU - Takada, Tadahiro

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Purpose: A multicenter survey was conducted to explore the role of adjuvant surgery for initially unresectable pancreatic cancer with a long-term favorable response to non-surgical cancer treatments. Methods: Clinical data including overall survival were retrospectively compared between 58 initially unresectable pancreatic cancer patients who underwent adjuvant surgery with a favorable response to non-surgical cancer treatments over 6 months after the initial treatment and 101 patients who did not undergo adjuvant surgery because of either unchanged unresectability, a poor performance status, and/or the patients' or surgeons' wishes. Results: Overall mortality and morbidity were 1.7 and 47 % in the adjuvant surgery group. The survival curve in the adjuvant surgery group was significantly better than in the control group (p < 0.0001). The propensity score analysis revealed that adjuvant surgery was a significant independent prognostic variable with an adjusted hazard ratio (95 % confidence interval) of 0.569 (0.36-0.89). Subgroup analysis according to the time from initial treatment to surgical resection showed a significant favorable difference in the overall survival in patients who underwent adjuvant surgery over 240 days after the initial treatment. Conclusion: Adjuvant surgery for initially unresectable pancreatic cancer patients can be a safe and effective treatment. The overall survival rate from the initial treatment is extremely high, especially in patients who received non-surgical anti-cancer treatment for more than 240 days.

AB - Purpose: A multicenter survey was conducted to explore the role of adjuvant surgery for initially unresectable pancreatic cancer with a long-term favorable response to non-surgical cancer treatments. Methods: Clinical data including overall survival were retrospectively compared between 58 initially unresectable pancreatic cancer patients who underwent adjuvant surgery with a favorable response to non-surgical cancer treatments over 6 months after the initial treatment and 101 patients who did not undergo adjuvant surgery because of either unchanged unresectability, a poor performance status, and/or the patients' or surgeons' wishes. Results: Overall mortality and morbidity were 1.7 and 47 % in the adjuvant surgery group. The survival curve in the adjuvant surgery group was significantly better than in the control group (p < 0.0001). The propensity score analysis revealed that adjuvant surgery was a significant independent prognostic variable with an adjusted hazard ratio (95 % confidence interval) of 0.569 (0.36-0.89). Subgroup analysis according to the time from initial treatment to surgical resection showed a significant favorable difference in the overall survival in patients who underwent adjuvant surgery over 240 days after the initial treatment. Conclusion: Adjuvant surgery for initially unresectable pancreatic cancer patients can be a safe and effective treatment. The overall survival rate from the initial treatment is extremely high, especially in patients who received non-surgical anti-cancer treatment for more than 240 days.

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