Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
권호 표지

Best Treatments in Borderline Resectable Advanced Pancreatic Cancer

  • Joon Seong Park (Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University Health System)
  • Received : 2016.11.30
  • Accepted : 2016.12.23
  • Published : 2016.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Pancreatic cancer is the lethal disease and the prognosis of pancreatic cancer has remained largely unchanged over the past years. Borderline advanced pancreatic cancer is a biological different from resectable pancreatic cancer due to higher risk of early recurrence because of artery/vein abutment. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. Some institutes managed borderline advanced pancreatic cancer by up-front neoadhuvant chemotherapy because neoadjuvant chemotherapy provide the opportunity to treat early micro-metastasis with unfavorable tumor biology. But, some institutes try aggressive up-front surgical procedures to provide a chance of long-term survival in highly selected patients. Therefore this unique subset of pancreatic cancer has a controversial issue with regard to their treatment policy. This review address recent treatment trend for patients with borderline advanced pancreatic cancer.

Keywords

References

  1. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-141.
  2. Appel BL, Tolat P, Evans DB, Tsai S. Current staging systems for pancreatic cancer. Cancer J 2012;18:539-549.
  3. Tempero MA, Malafa MP, Behrman SW, et al. Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw 2014;12:1083-1093.
  4. Evans DB, Farnell MB, Lillemoe KD, Vollmer C Jr, Strasberg SM, Schulick RD. Surgical treatment of resectable and borderline resectable pancreas cancer: expert consensus statement. Ann Surg Oncol 2009;16:1736-1744.
  5. Varadhachary GR,Wolff RA,Crane CH,e tal. Preoperative gemcitabine and cisplatin followed by gemcitabine-based chemoradiation for resectable adenocarcinoma of the pancreatic head. J Clin Oncol 2008;26:3487-3495.
  6. Katz MH, Marsh R, Herman JM, et al. Borderline resectable pancreatic cancer: need for standardization and methods for optimal clinical trial design. Ann Surg Oncol 2013;20:2787-2795.
  7. Evans DB, George B, Tsai S. Non-metastatic pancreatic cancer: resectable, borderline resectable, and locally advanced-definitions of increasing importance for the optimal delivery of multimodality therapy. Ann Surg Oncol 2015;22:3409-3413.
  8. Heestand GM, Murphy JD, Lowy AM. Approach to patients with pancreatic cancer without detectable metastases. J Clin Oncol 2015;33:1770-1778.
  9. Mehta VK, Fisher G, Ford JA, et al. Preoperative chemoradiation for marginally resectable adenocarcinoma of the pancreas. J Gastrointest Surg 2001;5:27-35
  10. Katz MH, Pisters PW, Evans DB, et al. Borderline resectable pancreatic cancer: the importance of this emerging stage of disease. J Am Coll Surg 2008;206:833-846; discussion 846-848
  11. Katz MH, Fleming JB, Bhosale P, et al. Response of borderline resectable pancreatic cancer to neoadjuvant therapy is not resected by radiographic indicators. Cancer 2012;118:5749-5756
  12. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 2011;364:1817-1825.
  13. Christians KK, Tsai S, Mahmoud A, et al. Neoadjuvant FOLFIRINOX for borderline resectable pancreas cancer: a new treatment paradigm? Oncologist 2014;19:266-274.
  14. Ferrone CR,Marchegiani G, Hong TS, et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRI-NOX for locally advanced and borderline resectable pancreatic cancer. Ann Surg 2015;261:12-17.
  15. Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab paclitaxel plus gemcitabine. N Engl J Med 2013;369:1691-1703.
  16. Tempero MA, Malafa MP, Behrman SW, et al. Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines, J Natl Compr Canc Netw 2014;12:1083-1093.
  17. Seufferlein T, Bachet JB, Van Cutsem E, Rougier P. ESMO guidelines working group. Pancreatic adenocarcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol 2012;23(Suppl 7): vii33-vii40.
  18. Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 2014;155:977-988.
  19. Beltrame V, Gruppo M, Pedrazzoli S, Merigliano S, Pastorelli D, Sperti C. Mesenteric-portal vein resection during pancreatectomy for pancreatic cancer. Gastroenterol Res Pract 2015;2015:659730.
  20. Zhou Y, Zhang Z, Liu Y, Li B, Xu D. Pancreatectomy combined with superior mesenteric vein-portal vein resection for pancreatic cancer: a meta-analysis. World J Surg 2012;36:884-891.
  21. Giovinazzo F, Turri G, Katz MH, Heaton N, Ahmed I. Meta-analysis of benefits of portal-superior mesenteric vein resection in pancreatic resection for ductal adenocarcinoma. Br J Surg 2016;103:179-191.
  22. Murakami Y, Satoi S, Motoi F, et al. Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma. Br J Surg 2015;102:837-846.
  23. Weitz J, Rahbari N, Koch M, Buchler MW. The "artery first" approach for resection of pancreatic head cancer. J Am Coll Surg 2010;210:e1-e4.
  24. Sanjay P, Takaori K, Govil S, Shrikhande SV, Windsor JA. 'Artery-first' approaches to pancreatoduodenectomy. Br J Surg 2012;99:1027-1035.
  25. Inoue Y, Saiura A, Yoshioka R, et al. Pancreatoduodenectomy with systematic mesopancreas dissection using a supracolic anterior artery-first approach. Ann Surg 2015;262:1092-1101.
  26. Sperti C, Berselli M, Pedrazzoli S. Distal pancreatectomy for body-tail pancreatic cancer: is there a role for celiac axis resection? Pancreatology 2010;10:491-498.
  27. Jing W, Zhu G, Hu X, et al. Distal pancreatectomy with en bloc celiac axis resection for the treatment of locally advanced pancreatic body and tail cancer. Hepatogastroenterology 2013;60:187-190.
  28. Strasberg Sm, Fields R. Left-sided pancreatic cancer: distal pancreatectomy and its variants: radical antegrade modular pancreatosplenectomy and distal pancreatectomy with celiac axis resection. Cancer J 2012;18:562-570.
  29. Hirano S, Kondo S, Hara T, et al. Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results. Ann Surg 2007;246:46-51.
  30. Miura T, Hirano S, Nakamura T, et al. A new preoperative prognostic scoring system to predict prognosis in patients with locally advanced pancreatic body cancer who undergo distal pancreatectomy with en bloc celiac axis resection: a retrospective cohort study. Surgery 2014;155:457-467.
  31. Okada K, Kawai M, Tani M, et al. Surgical strategy for patients with pancreatic body/tail carcinoma: who should undergo distal pancreatectomy with en-bloc celiac axis resection? Surgery 2013;153:365-372.