| セッション情報 | JDDW International Debate Session（Featured Lecture）4(JDDW)JDDW International Debate Session 「Treatment of borderline resectable pancreatic cancer （Surgery first vs Neoadjuvant therapy first）」 |
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| タイトル | IS1-4-2：Treatment of Borderline Resectable Pancreatic Cancer with Neoadjuvant Treatment |
| 演者 | P. W. T. Pisters（MD Anderson Cancer Center） |
| 共同演者 | |
| 抄録 | Borderline resectable pancreatic cancer is defined by anatomic criteria that are primarily defined by the absence of 1) visceral metastatic disease and 2) encasement (>180 degrees) of arterial structures that include the superior mesenteric artery (SMA) and celiac axis. This represents a unique subset of patients with pancreatic cancer that are increasingly being recognized as a result of higher quality imaging and increased understanding of the role of coordinated combined modality treatment for this subset of patients. We have developed a classification system and applied this prospectively to a consecutive series of patients with borderline disease. Patients were uniformly treated with induction gemcitabine-based chemotherapy followed by concurrent fluorouracil-based chemoradiation treatment. In a consecutive series of 162 patients, the overall resection rate was 43%, RO resection rate 96%, and median survival in resected patients of 40 months. These data provide single institution proof of principle that this subset of patients requires unique approaches and can achieve long-term survival with coordinated care. Pancreatic cancer specialists around the world should work to participate in collaborative efforts to enroll these patients in a series of clinical trials that require teamwork among surgeons. |
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