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Borderline resectable pancreatic cancer: rationale for multidisciplinary treatment

  • Shinichiro TakahashiEmail author
  • Taira Kinoshita
  • Masaru Konishi
  • Naoto Gotohda
  • Yuichiro Kato
  • Takahiro Kinoshita
  • Tatsushi Kobayashi
  • Syuichi Mitsunaga
  • Kohei Nakachi
  • Masafumi Ikeda
Original article

Abstract

Background

Borderline resectable pancreatic cancer (BRPC) appears to be most frequently related to a positive surgical margin and has a poor prognosis after resection. However, few reports are available on differences in tumor characteristics and prognoses among resectable pancreatic cancer (PC), BRPC, and unresectable PC.

Methods

Records of 133 patients resected for pancreatic ductal adenocarcinoma and 185 patients treated as locally advanced PC (LAPC) were reviewed.

Results

Twenty-four patients who initially underwent resection (BRPC-s) and 10 patients who were initially treated as LAPC (BRPC-n) met the criteria for BRPC. Prognosis of BRPC was significantly better than that of unresectable PC, but was significantly worse than that of resectable PC. BRPC-s showed more frequent nerve plexus invasion (P < 0.01), portal vein invasion (P < 0.01), and loco-regional recurrence (P = 0.03) than resectable PC. The positive surgical margin rate was not significantly higher in BRPC-s (29%) than in resectable PC (19%) (P = 0.41).

Conclusions

BRPC had a poorer prognosis with more local failure than resectable PC although prognosis of BRPC was significantly better than that of unresectable PC. Considering the tumor and treatment characteristics, multidisciplinary treatment including resection is required for BRPC.

Keywords

Pancreatic cancer Resection Borderline resectable pancreatic cancer 

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Copyright information

© Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2011

Authors and Affiliations

  • Shinichiro Takahashi
    • 1
    Email author
  • Taira Kinoshita
    • 1
  • Masaru Konishi
    • 1
  • Naoto Gotohda
    • 1
  • Yuichiro Kato
    • 1
  • Takahiro Kinoshita
    • 1
  • Tatsushi Kobayashi
    • 2
  • Syuichi Mitsunaga
    • 3
  • Kohei Nakachi
    • 3
  • Masafumi Ikeda
    • 3
  1. 1.Department of Hepatobiliary Pancreatic SurgeryNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Department of Diagnostic RadiologyNational Cancer Center Hospital EastChibaJapan
  3. 3.Department of Hepatobiliary Pancreatic OncologyNational Cancer Center Hospital EastChibaJapan

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