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Portal vein infusion chemotherapy with gemcitabine after surgery for pancreatic cancer

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Abstract

Purposes

Pancreatic cancer still has a poor prognosis even after curative resection because of the high incidence of postoperative liver metastasis. This study prospectively evaluated the feasibility and tolerability of portal vein infusion chemotherapy of gemcitabine (PVIG) as an adjuvant setting after pancreatic resection.

Methods

Thirteen patients enrolled in this study received postoperative chemotherapy with PVIG. The patients received intermittent administration of gemcitabine (800 mg/m2) via the portal vein on days 1, 8, and 15 after surgery. The tolerability and the toxicity of PVIG were closely monitored.

Results

The PVIG was started on an average of 3.1 days after surgery. Complete doses of chemotherapy (three sessions of portal infusion) were accomplished in 11 of the 13 patients. Grade 3 or 4 leukocytopenia was observed in three patients (23 %), and liver dysfunction was found in one patient (7.7 %). Grade 2 sepsis developed in two cases due to bloodstream infection. Liver metastasis was the first site of recurrence in only two patients.

Conclusions

PVIG can be administered to the liver with acceptable toxicity, but myelosuppression is similar to the systemic use of gemcitabine. Careful observation is required even for locoregional chemotherapy.

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Acknowledgments

The authors are grateful to Manabu Oyamatsu, MD, Sado General Hospital, for his valuable collaboration.

Conflict of interest

None.

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    Chi-e Kitami, Isao Kurosaki, Masahiro Minagawa, Kabuto Takano & Katsuyoshi Hatakeyama

  2. Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan

    Yasuyuki Kawachi

  3. Department of Surgery, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Japan

    Koei Nihei

  4. Department of Surgery, Niigata Cancer Center Niigata Hospital, Niigata, Japan

    Yoshiaki Tsuchiya & Tatsuya Nomura

Authors
  1. Chi-e Kitami
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  2. Isao Kurosaki
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  3. Yasuyuki Kawachi
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  4. Koei Nihei
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  5. Yoshiaki Tsuchiya
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  6. Tatsuya Nomura
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  7. Masahiro Minagawa
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  8. Kabuto Takano
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  9. Katsuyoshi Hatakeyama
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Consortia

Niigata study group of pancreatic cancer

Corresponding author

Correspondence to Isao Kurosaki.

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Kitami, Ce., Kurosaki, I., Kawachi, Y. et al. Portal vein infusion chemotherapy with gemcitabine after surgery for pancreatic cancer. Surg Today 43, 33–39 (2013). https://doi.org/10.1007/s00595-012-0179-8

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  • DOI: https://doi.org/10.1007/s00595-012-0179-8

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