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Recent treatment patterns and survival outcomes in pancreatic cancer according to clinical stage based on single-center large-cohort data
Ann Hepatobiliary Pancreat Surg 2018 Nov;22(4):386-96
Published online November 30, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Doo-ho Lee, Jin-Young Jang, Jae Seung Kang, Jae Ri Kim, Youngmin Han, Eunjung Kim, Wooil Kwon, Sun-Whe Kim

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Received May 18, 2018; Revised September 27, 2018; Accepted September 27, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: We performed a retrospective, single-center cohort study to evaluate the impact of various treatment modalities and recent changes in treatment modalities, including the increased application of chemotherapy, on survival in patients with pancreatic cancer. 
Methods: All patients with pancreatic cancer who were diagnosed and treated at Seoul National University Hospital between January 2007 and December 2014 were registered in a prospective clinical database and included in this retrospective study. All patients’ radiologic imaging diagnoses were re-reviewed according to the National Cancer Center Network guidelines. The patients were divided into four groups according to their clinical stage, and each clinical stage group was further divided into four groups according to treatment modality. 
Results: Overall, 475 (28.9%) patients had resectable pancreatic cancer, 129 (7.8%) patients borderline resectable pancreatic cancer, 384 (23.3%) patients locally advanced pancreatic cancer, and 658 (40.0%) patients metastatic pancreatic cancer. Among the patients with borderline resectable pancreatic cancer, the median survival was significantly longer in the neoadjuvant therapy (NAT)+surgery groups (24 months) than the surgery without NAT (16 months) group (p=0.049). A multivariate survival analysis revealed that compared with the surgery group, the 5-year mortality risk was decreased by 35% in the NAT+surgery group (24 vs. 20 months, p=0.045). 
Conclusions: This retrospective cohort study showed that the rates of resectable and surgically treatable pancreatic cancer were 29.1% and 32.2%, which are higher than those reported previously, and aggressive NAT for select advanced-stage patients could lead to better survival outcomes.
Keywords : Neoadjuvant therapy; Survival rate; Pancreas neoplasms

 

November 2018, 22 (4)