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Pancreatic Neoplasms: HELP
Articles by Goro Honda
Based on 32 articles published since 2010
(Why 32 articles?)
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Between 2010 and 2020, G. Honda wrote the following 32 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Clinical Trial Randomized phase II/III trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02/JSAP05). 2019

Motoi, Fuyuhiko / Kosuge, Tomoo / Ueno, Hideki / Yamaue, Hiroki / Satoi, Sohei / Sho, Masayuki / Honda, Goro / Matsumoto, Ippei / Wada, Keita / Furuse, Junji / Matsuyama, Yutaka / Unno, Michiaki / Anonymous4280974. ·Department of Surgery, Tohoku University School of Medicine, Sendai, Japan. · Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan. · Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tokyo, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Department of Surgery, Kansai Medical University, Osaka, Japan. · Department of Surgery, Nara Medical University, Nara, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan. · Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan. · Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. · Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan. · Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan. ·Jpn J Clin Oncol · Pubmed #30608598.

ABSTRACT: A randomized, controlled trial has begun to compare neoadjuvant chemotherapy using gemcitabine and S-1 with upfront surgery for patients planned resection of pancreatic cancer. Patients were enrolled after the diagnosis of resectable or borderline resectable by portal vein involvement pancreatic cancer with histological confirmation. They were randomly assigned to either neoadjuvant chemotherapy or upfront surgery. Adjuvant chemotherapy using S-1 was administered for 6 months to patients with curative resection who fully recovered within 10 weeks after surgery in both arms. The primary endpoint is overall survival; secondary endpoints include adverse events, resection rate, recurrence-free survival, residual tumor status, nodal metastases and tumor marker kinetics. The target sample size was required to be at least 163 (alpha-error 0.05; power 0.8) in both arms. A total of 360 patients were required after considering ineligible cases. This trial began in January 2013 and was registered with the UMIN Clinical Trials Registry (UMIN000009634).

2 Clinical Trial A single-arm, phase II trial of neoadjuvant gemcitabine and S1 in patients with resectable and borderline resectable pancreatic adenocarcinoma: PREP-01 study. 2019

Motoi, Fuyuhiko / Satoi, Sohei / Honda, Goro / Wada, Keita / Shinchi, Hiroyuki / Matsumoto, Ippei / Sho, Masayuki / Tsuchida, Akihiko / Unno, Michiaki / Anonymous361132. ·Department of Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. fmotoi@surg.med.tohoku.ac.jp. · Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata City, Osaka, 573-1010, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. · Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan. · Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. · Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan. · Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan. · Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. · Department of Surgery, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. ·J Gastroenterol · Pubmed #30182219.

ABSTRACT: BACKGROUND: Neoadjuvant chemotherapy (NAC) represents a promising alternative to pancreatic ductal adenocarcinoma (PDAC) planned resection, but the survival impact remains undefined. To assess the feasibility and survival outcomes of NAC with gemcitabine and S1 (GS) for PDAC planned resection by prospective study. METHODS: Patients with resectable or borderline resectable PDAC received 2 cycles of NAC-GS and were offered curative resection followed by gemcitabine adjuvant. The primary endpoint was 2-year overall survival (OS). Adverse events during NAC, radiological and tumor marker responses, resection rate, and surgical safety were evaluated as secondary endpoints (UMIN000004148). RESULTS: We enrolled 104 patients between 2010 and 2012, with 101 patients treated using NAC-GS as the full analysis set (FAS). Of the 101 patients, 88% received the planned 2 cycles of NAC. Grade 3 neutropenia was common (35%). Radiological partial response and decreased carbohydrate antigen 19-9 concentration (> 50% decrease) were noted in 13% and 41%, respectively. R0/1 resections with M0 were performed in 65 patients without surgical mortality. Of the 65 patients, 44 received planned gemcitabine adjuvant for 6 months as the on-protocol cohort. The primary endpoint for the 2-year OS rate was 55.9% in the FAS (n = 101) and 74.6% in the on-protocol cohort (n = 44). CONCLUSIONS: NAC-GS was feasible and actively prolonged survival following PDAC planned resection. Randomized control trials are needed to further clarify the survival benefit of NAC-GS in addition to surgery followed by adjuvant therapy.

3 Clinical Trial Multicenter Phase II Study of Intravenous and Intraperitoneal Paclitaxel With S-1 for Pancreatic Ductal Adenocarcinoma Patients With Peritoneal Metastasis. 2017

Satoi, Sohei / Fujii, Tsutomu / Yanagimoto, Hiroaki / Motoi, Fuyuhiko / Kurata, Masanao / Takahara, Naminatsu / Yamada, Suguru / Yamamoto, Tomohisa / Mizuma, Masamichi / Honda, Goro / Isayama, Hiroyuki / Unno, Michiaki / Kodera, Yasuhiro / Ishigami, Hironori / Kon, Masanori. ·*Department of Surgery, Kansai Medical University †Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine ‡Department of Surgery, Tohoku University Graduate School of Medicine §Department of Surgery, University of Tsukuba ¶Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo ||Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital **Department of Chemotherapy, the University of Tokyo. ·Ann Surg · Pubmed #28059968.

ABSTRACT: OBJECTIVE: To evaluate the clinical efficacy and tolerability of intravenous (i.v.) and intraperitoneal (i.p.) paclitaxel combined with S-1, "an oral fluoropyrimidine derivative containing tegafur, gimestat, and otastat potassium" in chemotherapy-naive pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal metastasis. BACKGROUND: PDAC patients with peritoneal metastasis (peritoneal deposits and/or positive peritoneal cytology) have an extremely poor prognosis. An effective treatment strategy remains elusive. METHODS: Paclitaxel was administered i.v. at 50 mg/m and i.p. at 20 mg/m on days 1 and 8. S-1 was administered at 80 mg/m/d for 14 consecutive days, followed by 7 days of rest. The primary endpoint was 1-year overall survival (OS) rate. The secondary endpoints were antitumor effect and safety (UMIN000009446). RESULTS: Thirty-three patients who were pathologically diagnosed with the presence of peritoneal dissemination (n = 22) and/or positive peritoneal cytology (n = 11) without other organ metastasis were enrolled. The tumor was located at the pancreatic head in 7 patients and the body/tail in 26 patients. The median survival time was 16.3 (11.47-22.57) months, and the 1-year survival rate was 62%. The response rate and disease control rate in assessable patients were 36% and 82%, respectively. OS in 8 patients who underwent conversion surgery was significantly higher than that of nonsurgical patients (n = 25, P = 0.0062). Grade 3/4 hematologic toxicities occurred in 42% of the patients and nonhematologic adverse events in 18%. One patient died of thrombosis in the superior mesenteric artery. CONCLUSIONS: This regimen has shown promising clinical efficacy with acceptable tolerability in chemotherapy-naive PDAC patients with peritoneal metastasis.

4 Clinical Trial A Phase I Study of S-1 and Gemcitabine with Concurrent Radiotherapy in Patients with Non-Metastatic Advanced Pancreatic Cancer. 2015

Kobayashi, Shin / Honda, Goro / Kurata, Masanao / Okuda, Yukihiro / Sakamoto, Katsunori / Karasawa, Katsuyuki / Chang, Tachen / Egawa, Naoto / Kamisawa, Terumi / Omuro, Yasushi / Tsuruta, Koji. · ·Hepatogastroenterology · Pubmed #26902051.

ABSTRACT: BACKGROUND/AIMS: To determine the recommended dose (RD) for full-dose S-1 and low-dose gemcitabine combined with radiotherapy in patients with non-metastatic advanced pancreatic cancer. METHODOLOGY: Adult patients with non-metastatic advanced pancreatic cancer (Union for International Cancer Control T stage 3 or 4) were eligible. The weekly intravenous gemcitabine (level 0-1: 200 mg/ml,level 2: 300 mg/m on Days 1, 8, 15, 22, 29, 36) dose was escalated starting from level 1 in a 3+3 design along with full dose twice-daily oral S-1 (level 0: 60 mg/m2/day, level 1-2: 80 mg/ml/day), and was administered on the same days as radiotherapy (1.8 Gy x 28 days). RESULTS: Eight patients were included in this study. A dose-limiting toxicity (DLT) (grade 4 neutropenia) was observed in one of the first three patients in level 1, and three additional patients received the level 1 dose without any severe adverse events. DLTs (grade 3/4 neutropenia) were then observed in the first two patients given level 2 dose. Therefore, level 1 was designated as the RD. Common grade 3/4 toxicities included neutropenia (62.5%), anorexia (37.5%), and pneumonitis (12.5%). CONCLUSIONS: The combination of S-1 and gemcitabine with concurrent radiotherapy is a feasible regimen at the level 1 dose.

5 Article Decreased serum carbohydrate antigen 19-9 levels after neoadjuvant therapy predict a better prognosis for patients with pancreatic adenocarcinoma: a multicenter case-control study of 240 patients. 2019

Aoki, Shuichi / Motoi, Fuyuhiko / Murakami, Yoshiaki / Sho, Masayuki / Satoi, Sohei / Honda, Goro / Uemura, Kenichiro / Okada, Ken-Ichi / Matsumoto, Ippei / Nagai, Minako / Yanagimoto, Hiroaki / Kurata, Masanao / Fukumoto, Takumi / Mizuma, Masamichi / Yamaue, Hiroki / Unno, Michiaki / Anonymous1210984. ·Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8574, Japan. · Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8574, Japan. fmotoi@surg.med.tohoku.ac.jp. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan. · Department of Surgery, Nara Medical University, Nara, 634-8521, Japan. · Department of Surgery, Kansai Medical University, Osaka, 573-1010, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, 113-8677, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, 641-8510, Japan. · Department of Surgery, Kindai University Faculty of Medicine, Osaka, 577-8502, Japan. · Department of Gastointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, 305-8575, Japan. · Department of Surgery, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan. ·BMC Cancer · Pubmed #30898101.

ABSTRACT: BACKGROUND: Carbohydrate antigen (CA) 19-9 levels after resection are considered to predict prognosis; however, the significance of decreased CA19-9 levels after neoadjuvant therapy has not been clarified. This study aimed to define the prognostic significance of decreased CA19-9 levels after neoadjuvant therapy in patients with pancreatic adenocarcinoma. METHODS: Between 2001 and 2012, 240 consecutive patients received neoadjuvant therapy and subsequent resection at seven high-volume institutions in Japan. These patients were divided into three groups: Normal group (no elevation [≤37 U/ml] before and after neoadjuvant therapy), Responder group (elevated levels [> 37 U/ml] before neoadjuvant therapy but decreased levels [≤37 U/ml] afterwards), and Non-responder group (elevated levels [> 37 U/ml] after neoadjuvant therapy). Analyses of overall survival and recurrence patterns were performed. Uni- and multivariate analyses were performed to clarify the clinicopathological factors influencing overall survival. The initial metastasis sites were also evaluated in these groups. RESULTS: The Responder group received a better prognosis than the Non-responder group (3-year overall survival: 50.6 and 41.6%, respectively, P = 0.026), but the prognosis was comparable to the Normal group (3-year overall survival: 54.2%, P = 0.934). According to the analysis of the receiver operating characteristic curve, the CA19-9 cut-off level defined as no elevation after neoadjuvant therapy was ≤103 U/ml. The multivariate analysis revealed that a CA19-9 level ≤ 103 U/ml, (P = 0.010, hazard ratio: 1.711; 95% confidence interval: 1.133-2.639), tumor size ≤27 mm (P = 0.040, 1.517; (1.018-2.278)), a lack of lymph node metastasis (P = 0.002, 1.905; (1.276-2.875)), and R0 status (P = 0.045, 1.659; 1.012-2.627) were significant predictors of overall survival. Moreover, the Responder group showed a lower risk of hepatic recurrence (18%) compared to the Non-responder group (31%), though no significant difference in loco-regional, peritoneal or other distant recurrence were observed between groups (P = 0.058, P = 0.700 and P = 0.350, respectively). CONCLUSIONS: Decreased CA19-9 levels after neoadjuvant therapy predicts a better prognosis, with low incidence of hepatic recurrence after surgery.

6 Article Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer. 2019

Terada, Shuzo / Kikuyama, Masataka / Kawaguchi, Shinya / Kanemoto, Hideyuki / Yokoi, Yoshihiro / Kamisawa, Terumi / Kuruma, Sawako / Chiba, Kazuro / Honda, Goro / Horiguchi, Shinichiro / Nakahodo, Jun. ·Department of Gastroenterology, Shizuoka General Hospital, Shizuoka 420-8527, Japan. m01060st@jichi.ac.jp. · Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, Japan. kikuyama110@yahoo.co.jp. · Department of Gastroenterology, Shizuoka General Hospital, Shizuoka 420-8527, Japan. shinya-kawaguchi@i.shizuoka-pho.jp. · Department of Surgery, Shizuoka General Hospital, Shizuoka 420-8527, Japan. kanemot@gmail.com. · Department of Surgery, Shinshiro Municipal Hospital, Aichi 441-1387, Japan. y.yokoi@shinshirohp.jp. · Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, Japan. kamisawa@cick.jp. · Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, Japan. sawako@cick.jp. · Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-0021, Japan. kazuro_oruzak@yahoo.co.jp. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan. ghon@cick.jp. · Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan. s.horiguchi@cick.jp. · Department of Human Pathology, Juntendo University, Tokyo 113-8421, Japan. nakajun58@yahoo.co.jp. ·Diagnostics (Basel) · Pubmed #30678056.

ABSTRACT: BACKGROUNDS: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. MATERIALS AND METHODS: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included. The preoperative EUS findings were classified as follows. A1: Simple stricture type-no findings around the stricture; A2: Hypoecho stricture type-localized hypoechoic area without demarcation around the stricture; A3: Tumor stricture type-tumor on the stricture; B: Dilation type-the dilation of the pancreatic duct without a downstream stricture; C: Parenchymal tumor type-tumor located apart from the MPD. RESULTS: Classes A1 and A2 consisted of 2 CISs, and 4 invasive carcinomas included two cases smaller than 5 mm in diameter. Most of the cancers classified as A3 or C were of invasive carcinoma larger than 5 mm in diameter. All cancers classified as B involved CIS. Serial pancreatic-juice aspiration cytologic examination (SPACE) was selected for all types of cases, with a sensitivity of 92.0%, while EUS-guided fine needle aspiration cytology (EUS-FNA) was only useful for invasive carcinoma, and its sensitivity was 66.7%. CONCLUSIONS: Stricture without a tumor could be a finding for invasive PC and pancreatic duct dilation without a downstream stricture could be a finding indicative of CIS. Carcinoma smaller than 5 mm in diameter could not be recognized by EUS. SPACE had a high sensitivity for diagnosing small PC.

7 Article Sustained Elevation of Postoperative Serum Level of Carbohydrate Antigen 19-9 is High-Risk Stigmata for Primary Hepatic Recurrence in Patients with Curatively Resected Pancreatic Adenocarcinoma. 2019

Motoi, Fuyuhiko / Murakami, Yoshiaki / Okada, Ken-Ichi / Matsumoto, Ippei / Uemura, Kenichiro / Satoi, Sohei / Sho, Masayuki / Honda, Goro / Fukumoto, Takumi / Yanagimoto, Hiroaki / Kinoshita, Shoichi / Kurata, Masanao / Aoki, Shuichi / Mizuma, Masamichi / Yamaue, Hiroki / Unno, Michiaki / Anonymous4720964. ·Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. fmotoi@surg.med.tohoku.ac.jp. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. · Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan. · Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan. · Department of Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. · Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. · Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. ·World J Surg · Pubmed #30298281.

ABSTRACT: BACKGROUND: Survival after surgery for pancreatic adenocarcinoma (PA) is poor and heterogeneous, even for curative (R0) resection. Serum carbohydrate antigen (CA) 19-9 levels are important prognostic markers for resected PA. However, sustained elevation of CA19-9 in association with the patterns of recurrence has been rarely investigated. METHODS: Patients who underwent R0 resection (n = 539) were grouped according to postoperative serum CA19-9 levels (Group E: sustained elevation; Group N: no elevation). Clinicopathological factors, patterns of recurrence, and survival were compared between the groups. RESULTS: Group E (n = 159) had significantly shorter median overall survival (17.1 vs. 35.4 months, p < 0.0001) than Group N (n = 380). Postoperative CA19-9 elevation was a significant independent predictor of poor survival in multivariate analysis (hazard ratio 1.98, p < 0.0001). The rate of hepatic recurrence in Group E was 2.6-fold higher than in Group N (45% vs. 17%, p < 0.0001). Postoperative CA19-9 elevation was a strongest independent predictor of primary hepatic recurrence (p < 0.0001) by a multiple regression model. Loco-regional, peritoneal, and other distant recurrence did not differ between the groups. The extent of preoperative CA19-9 elevation was correlated sustained elevation of CA19-9 after surgery (p < 0.0001) and primary hepatic recurrence (p = 0.0019). CONCLUSIONS: Sustained CA19-9 elevation was strong predictor of primary hepatic recurrence and short survival in cases of R0 resection for PA.

8 Article Minimally invasive preservation versus splenectomy during distal pancreatectomy: a systematic review and meta-analysis. 2018

Nakata, Kohei / Shikata, Satoru / Ohtsuka, Takao / Ukai, Tomohiko / Miyasaka, Yoshihiro / Mori, Yasuhisa / Velasquez, Vittoria Vanessa D M / Gotoh, Yoshitaka / Ban, Daisuke / Nakamura, Yoshiharu / Nagakawa, Yuichi / Tanabe, Minoru / Sahara, Yatsuka / Takaori, Kyoichi / Honda, Goro / Misawa, Takeyuki / Kawai, Manabu / Yamaue, Hiroki / Morikawa, Takanori / Kuroki, Tamotsu / Mou, Yiping / Lee, Woo-Jung / Shrikhande, Shailesh V / Tang, Chung Ngai / Conrad, Claudius / Han, Ho-Seong / Chinnusamy, Palanivelu / Asbun, Horacio J / Kooby, David A / Wakabayashi, Go / Takada, Tadahiro / Yamamoto, Masakazu / Nakamura, Masafumi. ·Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Mie Prefectural Ichishi Hospital, Tsu-Shi, Mie, Japan. · Department of Community Medicine, Mie University School of Medicine, Tsu, Mie, Japan. · Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. · Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. · Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan. · Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Kyoto, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. · Department of Surgery, Tokyo Jikei University School of Medicine, Tokyo, Japan. · Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan. · Department of Surgery, Tohoku University, Sendai, Japan. · Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki, Japan. · Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, China. · Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, Korea. · Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Hospital, Mumbai, India. · Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea. · Division of Gastrointestinal Surgery and Minimal Access Surgery, GEM Hospital and Research Centre, Coimbatore, India. · Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. · Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA. · Department of Surgery, Ageo Central General Hospital, Ageo, Japan. · Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. · Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. ·J Hepatobiliary Pancreat Sci · Pubmed #29943909.

ABSTRACT: BACKGROUND: Minimally invasive distal pancreatectomy (MIDP) has gained in popularity recently. However, there is no consensus on whether to preserve the spleen or not. In this study, we compared MIDP outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS); as well as outcomes between splenic vessel preservation (SVP) and Warshaw's technique (WT). METHODS: A systematic search of PubMed (MEDLINE) and Cochrane Library was conducted and the reference lists of review articles were hand-searched. RESULTS: Fifteen relevant studies with 769 patients were selected for meta-analyses of DPS and SPDP, while another 15 studies with 841 patients were used for the analysis between SVP and WT. Compared with the DPS group, SPDP patients had significantly lower incidences of infectious complications (P = 0.006) and pancreatic fistula (P = 0.002), shorter operative time (P < 0.001), and less blood loss (P = 0.01). Compared with WT, SVP patients had significantly lower incidences of splenic infarction (P < 0.001) and secondary splenectomy (P = 0.003). Subanalysis for laparoscopic surgery alone had similar results. CONCLUSIONS: Based on this study, SPDP has significantly superior outcomes compared to DPS. When a spleen is preserved, SVP has better outcomes over WT for reducing splenic complications.

9 Article International Summit on Laparoscopic Pancreatic Resection (ISLPR) "Coimbatore Summit Statements". 2018

Palanivelu, Chinnusamy / Takaori, Kyoichi / Abu Hilal, Mohammad / Kooby, David A / Wakabayashi, Go / Agarwal, Anil / Berti, Stefano / Besselink, Marc G / Chen, Kuo Hsin / Gumbs, Andrew A / Han, Ho-Seong / Honda, Goro / Khatkov, Igor / Kim, Hong Jin / Li, Jiang Tao / Duy Long, Tran Cong / Machado, Marcel Autran / Matsushita, Akira / Menon, Krish / Min-Hua, Zheng / Nakamura, Masafumi / Nagakawa, Yuichi / Pekolj, Juan / Poves, Ignasi / Rahman, Shahidur / Rong, Liu / Sa Cunha, Antonio / Senthilnathan, Palanisamy / Shrikhande, Shailesh V / Gurumurthy, S Srivatsan / Sup Yoon, Dong / Yoon, Yoo-Seok / Khatri, Vijay P. ·Division of Gastrointestinal Surgery and Minimal Access Surgery, GEM Hospital and Research Centre, Coimbatore, India. Electronic address: palanivelu@mac.com. · Division of Hapato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Division of HPB Surgery, Southampton General Hospital (NHS), Southampton, UK. · Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, United States. · Department of Surgery, Ageo Central General Hospital, Saitama, Japan. · Department of Surgical Gastroenterology, G B Pant Hospital, Delhi, India. · Division of Miniinvasive Surgery, S. Andrea Hospital, La Spezia, Italy. · Hepato-Pancreato- Biliary (HPB) Surgery, Academic Medical Center, Amsterdam, The Netherlands. · Department of Surgery, Far-Eastern Memorial Hospital, Taiwan. · Department of Surgical Oncology, Summit Medical Group-MD Anderson Cancer Center, Berkeley Heights, NJ, USA. · Comprehensive Cancer Center, Seoul National University Bundang Hospital, Bundang, South Korea. · Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. · Surgical Oncology, Moscow Clinical Scientific Center, Moscow, Russia. · Department of HBP Surgery, Yeungnam University Hospital, Daegu, South Korea. · Department of Surgery, Second Affiliated Hospital, Zhejiang University, Hangzhou, China. · Department of General Surgery, University Medical Center in Ho Chi Minh City Vietnam, Ho Chi Minh, Viet Nam. · Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil. · Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. · Division and/or Department - Institute of Liver Studies, Department of Liver Transplantation and HPB, King's College Hospital NHS Trust, Camberwell, UK. · Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. · Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan. · General Surgery Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. · Department of Surgery, Hospital del Mar, Barcelona, Spain. · Hepatobiliary Pancreatic and Liver Transplant Division, Bangobandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. · The Military Institute of Hepato-Pancreatico-Biliary Surgery and Second Department of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China. · Department of HPB Surgery, AP-HP Hôpital Paul Brousse, Paris, France. · Division of Minimally Invasive, Liver Transplantation & HPB Surgery, GEM Hosptial & Research Centre, Coimbatore, India. · Division of Cancer Surgery / Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India. · Division of HPB & Minimal Access Surgery, GEM Hosptial & Research Centre, Coimbatore, India. · Department of Surgery, Gangnam Severance Hospital, Yonsei University Health System, Seoul, South Korea. · Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea. · Department of Oncology, California Northstate University College of Medicine, Elk Grove, California, USA. ·Surg Oncol · Pubmed #29371066.

ABSTRACT: The International Summit on Laparoscopic Pancreatic Resection (ISLPR) was held in Coimbatore, India, on 7th and 8th of October 2016 and thirty international experts who regularly perform laparoscopic pancreatic resections participated in ISPLR from four continents, i.e., South and North America, Europe and Asia. Prior to ISLPR, the first conversation among the experts was made online on August 26th, 2016 and the structures of ISPLR were developed. The aims of ISPLR were; i) to identify indications and optimal case selection criteria for minimally invasive pancreatic resection (MIPR) in the setting of both benign and malignant diseases; ii) standardization of techniques to increase the safety of MIPR; iii) identification of common problems faced during MIPR and developing associated management strategies; iv) development of clinical protocols to allow early identification of complications and develop the accompanying management plan to minimize morbidity and mortality. As a process for interactive discussion, the experts were requested to complete an online questionnaire consisting of 65 questions about the various technical aspects of laparoscopic pancreatic resections. Two further web-based meetings were conducted prior to ISPLR. Through further discussion during ISPLR, we have created productive statements regarding the topics of Disease, Implementation, Patients, Techniques, and Instrumentations (DIPTI) and hereby publish them as "Coimbatore Summit Statements".

10 Article Is distal pancreatectomy with en-bloc celiac axis resection effective for patients with locally advanced pancreatic ductal adenocarcinoma? -Multicenter surgical group study. 2018

Yamamoto, Tomohisa / Satoi, Sohei / Kawai, Manabu / Motoi, Fuyuhiko / Sho, Masayuki / Uemura, Ken-Ichiro / Matsumoto, Ippei / Honda, Goro / Okada, Ken-Ichi / Akahori, Takahiro / Toyama, Hirochika / Kurata, Masanao / Yanagimoto, Hiroaki / Yamaue, Hiroki / Unno, Michiaki / Kon, Masanori / Murakami, Yoshiaki. ·Department of Surgery, Kansai Medical University, Japan. · Department of Surgery, Kansai Medical University, Japan. Electronic address: satoi@hirakata.kmu.ac.jp. · Second Department of Surgery, Wakayama Medical University, Japan. · Department of Surgery, Tohoku University Graduate School of Medicine, Japan. · Department of Surgery, Nara Medical University, Japan. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Japan. · Department of Surgery, Kindai University Faculty of Medicine, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Japan. · Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Japan. ·Pancreatology · Pubmed #29153701.

ABSTRACT: OBJECTIVES: We retrospectively investigated the operative outcomes of patients who underwent distal pancreatectomy (DP) for invasive pancreatic ductal adenocarcinoma (PDAC) located at the body and tail. METHODS: Data from 395 patients with PDAC who underwent DP with margin-negative resection (R0 or R1) were collected from seven high-volume centers in Japan from 2001 to 2012. Among them, 72 patients underwent DP with en-bloc celiac axis resection (DP-CAR). The remaining 323 patients underwent conventional DP with splenectomy (DP-S). To determine the efficacy of DP-CAR, clinicopathological data were compared between the DP-CAR and the DP-S groups. RESULTS: The DP-S group consisted mainly of patients with resectable disease (93%), and conversely, all patients in the DP-CAR group had borderline resectable or unresectable disease. The overall morbidity was significantly higher in the DP-CAR group than in the DP-S group (63% vs 47%, respectively; P = 0.017). The median survival time (MST) of the DP-CAR group was significantly shorter than that of the DP-S group (17.5 vs 28.6 months, respectively; P = 0.004). However, the MST of patients in the DP-CAR group (n = 61, 85%) who received adjuvant therapy was significantly longer than that of patients in the DP-S group (n = 65, 20%) who underwent R1 resection (21.9 vs 16.7 months, respectively; P = 0.024). CONCLUSION: DP-CAR followed by adjuvant chemotherapy provided an acceptable overall survival rate in patients with highly advanced PDAC, but should be performed with great caution because of high morbidity. Patients with a high risk of positive surgical margins with DP-S may be candidates for DP-CAR.

11 Article Retrospective Study of the Correlation Between Pathological Tumor Size and Survival After Curative Resection of T3 Pancreatic Adenocarcinoma: Proposal for Reclassification of the Tumor Extending Beyond the Pancreas Based on Tumor Size. 2017

Kurata, Masanao / Honda, Goro / Murakami, Yoshiaki / Uemura, Kenichiro / Satoi, Sohei / Motoi, Fuyuhiko / Sho, Masayuki / Matsumoto, Ippei / Kawai, Manabu / Yanagimoto, Hiroaki / Fukumoto, Takumi / Nagai, Minako / Gosho, Masahiko / Unno, Michiaki / Yamaue, Hiroki / Anonymous430910. ·Department of Gastrointestinal and Hepato-biliary-Pancreatic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan. mkurata@md.tsukuba.ac.jp. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. · Department of Surgery, Kansai Medical University, Osaka, Japan. · Division of Gastroenterological Surgery, Department of Surgery, Tohoku University, Sendai, Japan. · Department of Surgery, Nara Medical University, Nara, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Department of Clinical Trial and Clinical Epidemiology, University of Tsukuba, Tsukuba, Japan. ·World J Surg · Pubmed #28620676.

ABSTRACT: BACKGROUND: Even though most patients who undergo resection of pancreatic adenocarcinoma have T3 disease with extra-pancreatic tumor extension, T3 disease is not currently classified by tumor size. The aim of this study was to modify the current TNM classification of pancreatic adenocarcinoma to reflect the influence of tumor size. METHODS: A total of 847 consecutive pancreatectomy patients were recruited from multiple centers. Optimum tumor size cutoff values were calculated by receiver operating characteristics analysis for tumors limited to the pancreas (T1/2) and for T3 tumors. In our modified TNM classification, stage II was divided into stages IIA (T3aN0M0), IIB (T3bN0M0), and IIC (T1-3bN1M0) using tumor size cutoff values. The usefulness of the new classification was compared with that of the current classification using Akaike's information criterion (AIC). RESULTS: The optimum tumor size cutoff value distinguishing T1 and T2 was 2 cm, while T3 was divided into T3a and T3b at a tumor size of 3 cm. The median survival time of the stages IIA, IIB, and IIC were 44.7, 27.6, and 20.3 months, respectively. There were significant differences of survival between stages IIA and IIB (P = 0.02) and between stages IIB and IIC (P = 0.03). The new classification showed better performance compared with the current classification based on the AIC value. CONCLUSIONS: This proposed new TNM classification reflects the influence of tumor size in patients with extra-pancreatic tumor extension (T3 disease), and the classification is useful for predicting mortality.

12 Article Proposed Nomogram Predicting the Individual Risk of Malignancy in the Patients With Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas. 2017

Jang, Jin-Young / Park, Taesung / Lee, Selyeong / Kim, Yongkang / Lee, Seung Yeoun / Kim, Sun-Whe / Kim, Song-Cheol / Song, Ki-Byung / Yamamoto, Masakazu / Hatori, Takashi / Hirono, Seiko / Satoi, Sohei / Fujii, Tsutomu / Hirano, Satoshi / Hashimoto, Yasushi / Shimizu, Yashuhiro / Choi, Dong Wook / Choi, Seong Ho / Heo, Jin Seok / Motoi, Fuyuhiko / Matsumoto, Ippei / Lee, Woo Jung / Kang, Chang Moo / Han, Ho-Seong / Yoon, Yoo-Seok / Sho, Masayuki / Nagano, Hiroaki / Honda, Goro / Kim, Sang Geol / Yu, Hee Chul / Chung, Jun Chul / Nagakawa, Yuichi / Seo, Hyung Il / Yamaue, Hiroki. ·*Department of Surgery, Seoul National University College of Medicine, Seoul, Korea †Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea ‡Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea §Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea ¶Department of Surgery, Tokyo Women's Medical University, Institute of Gastroenterology, Tokyo, Japan ||Department of Surgery, International University of Health and Welfare Mita Hospital, Surgery, Tokyo Women's Medical University, Institute of Gastroenterology, Tokyo, Japan **Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan ††Department of Surgery, Kansai Medical University, Moriguchi, Osaka, Japan ‡‡Department of Surgery, Nagoya University, Nagoya, Japan §§Department of Surgery, Hokkaido University, Hokkaido, Japan ¶¶Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan ||||Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan ***Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea †††Department of Surgery, Tohoku University, Tohoku, Japan ‡‡‡Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan §§§Pancreaticobiliary Cancer Clinic, Yonsei University College of Medicine, Yonsei Cancer Center, Severance Hospital, Surgery, Seoul, Korea ¶¶¶Department of Surgery, Seoul National University Bundang Hospital, Surgery, Seoul National University College of Medicine, Seoul, Korea ||||||Department of Surgery, Seoul National University College of Medicine, Surgery, Seoul National University Bundang Hospital, Seoul, Korea ****Department of Surgery, Nara Medical University, Nara, Japan ††††Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan ‡‡‡‡Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan §§§§Department of Surgery, Kyungpook National University, Daegu, Korea ¶¶¶¶Department of Surgery, Chonbuk National University, Jeonju, Korea ||||||||Department of Surgery, Soonchunhyang University, Asan, Korea *****Department of Surgery, Tokyo Medical University, Tokyo, Japan †††††Department of Surgery, Pusan National University, Pusan, Korea. ·Ann Surg · Pubmed #27607098.

ABSTRACT: OBJECTIVES: This study evaluated individual risks of malignancy and proposed a nomogram for predicting malignancy of branch duct type intraductal papillary mucinous neoplasms (BD-IPMNs) using the large database for IPMN. BACKGROUND: Although consensus guidelines list several malignancy predicting factors in patients with BD-IPMN, those variables have different predictability and individual quantitative prediction of malignancy risk is limited. METHODS: Clinicopathological factors predictive of malignancy were retrospectively analyzed in 2525 patients with biopsy proven BD-IPMN at 22 tertiary hospitals in Korea and Japan. The patients with main duct dilatation >10 mm and inaccurate information were excluded. RESULTS: The study cohort consisted of 2258 patients. Malignant IPMNs were defined as those with high grade dysplasia and associated invasive carcinoma. Of 2258 patients, 986 (43.7%) had low, 443 (19.6%) had intermediate, 398 (17.6%) had high grade dysplasia, and 431 (19.1%) had invasive carcinoma. To construct and validate the nomogram, patients were randomly allocated into training and validation sets, with fixed ratios of benign and malignant lesions. Multiple logistic regression analysis resulted in five variables (cyst size, duct dilatation, mural nodule, serum CA19-9, and CEA) being selected to construct the nomogram. In the validation set, this nomogram showed excellent discrimination power through a 1000 times bootstrapped calibration test. CONCLUSION: A nomogram predicting malignancy in patients with BD-IPMN was constructed using a logistic regression model. This nomogram may be useful in identifying patients at risk of malignancy and for selecting optimal treatment methods. The nomogram is freely available at http://statgen.snu.ac.kr/software/nomogramIPMN.

13 Article [Neoadjuvant Chemotherapy Using S-1 for Pancreatic Cancer - Mid-Term Results]. 2016

Homma, Yuki / Honda, Goro / Sakamoto, Katsunori / Kurata, Masanao / Honjo, Masahiko / Hirata, Yoshihiro / Shinya, Satoshi. ·Dept. of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital. ·Gan To Kagaku Ryoho · Pubmed #27760934.

ABSTRACT: BACKGROUND: Although surgical resection is the only curative strategy for pancreatic cancer, the prognosis of patients with pancreatic cancer remains poor. Recently, neoadjuvant treatment has been frequently employed as a promising treatment. Here, the mid-term results of neoadjuvant chemoradiotherapy(NACRT)using S-1, which has been performed in our hospital since 2008, are reported. METHODS: Seventy-nine patients with resectable or borderline resectable pancreatic ductal adenocarcinoma, who had been intended to undergo NACRT treatment using S-1, were enrolled. The NACRT comprised radiotherapy( 1.8 Gy×28 days)and full-dose twice-daily oral S-1 given on the same days as the radiotherapy. The results of the NACRT and pancreatectomy and the patients' prognoses were evaluated. RESULTS: Fifty-five patients(69.6%)underwent pancreatectomy, with no case of mortality. The curative resection rate was 94.5%. Postoperative adjuvant chemotherapy was administered in 46 patients(83.6%). The 3-year survival rates of all 79 patients and 55 pancreatectomy patients were 40.1% and 50.4%, respectively. CONCLUSION: NACRT using S-1 was found to be feasible, and good mid-term outcomes were obtained. However, analysis of the long-term outcomes and comparisons with other novel anti-cancer drugs are still required.

14 Article Grade B pancreatic fistulas do not affect survival after pancreatectomy for pancreatic cancer: A multicenter observational study. 2016

Kawai, Manabu / Murakami, Yoshiaki / Motoi, Fuyuhiko / Sho, Masayuki / Satoi, Sohei / Matsumoto, Ippei / Honda, Goro / Hirono, Seiko / Okada, Ken-Ichi / Unno, Michiaki / Nakajima, Yoshiyuki / Uemura, Kenichiro / Kwon, A-Hon / Fukumoto, Takumi / Kurata, Masanao / Yamaue, Hiroki. ·Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. · Division of Gastroenterological Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. · Department of Surgery, Nara Medical University, Nara, Japan. · Department of Surgery, Kansai Medical University, Hirakata, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. Electronic address: yamaue-h@wakayama-med.ac.jp. ·Surgery · Pubmed #27083480.

ABSTRACT: BACKGROUND: Several studies have demonstrated that postoperative complications after pancreatectomy for pancreatic cancer adversely affect survival. The impact on survival of a pancreatic fistula according to the classification of the International Study Group for Pancreatic Surgery has not been fully evaluated. The aim of this multicenter, observational study was to evaluate the impact of pancreatic fistula on pancreatic cancer patients who had undergone pancreatectomy. METHODS: Between 2001 and 2012, 1,397 patients who underwent pancreatectomy for pancreatic cancer at 7 high-volume centers in Japan were reviewed retrospectively. The impact of pancreatic fistula on survival was evaluated by univariate and multivariate analysis. RESULTS: Pancreatic fistula occurred in 327 of 1,397 patients (23.4%) and was classified based on the International Study Group for Pancreatic Surgery as follows: grade A in 9.9%, grade B in 10.6%, and grade C in 2.9% of the patients. Median survival time in no fistula/grade A, grade B, and grade C were 23.6, 26.0, and 9.0 months, respectively. There was no significant difference in overall survival between patients with no fistula/grade A and those with grade B (P = .403); in contrast, overall survival in patients with grade C was worse than in patients without grade C (P < .001). The multivariate Cox proportional hazard analysis demonstrated that grade C pancreatic fistula was an independent prognostic factor (hazard ratio 1.59; 95% confidence interval, 1.03-2.45; P = .035). CONCLUSION: Grade B pancreatic fistula after pancreatectomy does not adversely affect long-term survival, but a grade C pancreatic fistula has a negative impact on long-term survival of patients with pancreatic cancer.

15 Article Prognosis after surgical treatment for pancreatic cancer in patients aged 80 years or older: a multicenter study. 2016

Sho, Masayuki / Murakami, Yoshiaki / Kawai, Manabu / Motoi, Fuyuhiko / Satoi, Sohei / Matsumoto, Ippei / Honda, Goro / Uemura, Kenichiro / Yanagimoto, Hiroaki / Kurata, Masanao / Akahori, Takahiro / Kinoshita, Shoichi / Nagai, Minako / Nishiwada, Satoshi / Fukumoto, Takumi / Unno, Michiaki / Yamaue, Hiroki / Nakajima, Yoshiyuki. ·Department of Surgery, Nara Medical University, Nara, Japan. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Division of Gastroenterological Surgery, Department of Surgery, Tohoku University, Sendai, Japan. · Department of Surgery, Kansai Medical University, Osaka, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. ·J Hepatobiliary Pancreat Sci · Pubmed #26763744.

ABSTRACT: BACKGROUND: The optimal therapeutic strategy for very elderly pancreatic cancer patients remains to be determined. The aim of this study was to clarify the role of pancreatic resection in patients 80 years of age or older. METHODS: A retrospective multicenter analysis of 1401 patients who had undergone pancreatic resection for pancreatic cancer was performed. The patients aged ≥ 80 years (n = 99) were compared with a control group <80 years of age (n = 1302). RESULTS: There were no significant differences in the postoperative complications and mortality between the two groups. However, the prognosis of octogenarians was poorer than that of younger patients for both resectable and borderline resectable tumors. Importantly, there were few long-term survivors in the elderly group, especially among those with borderline resectable pancreatic cancer. A multivariate analysis of the prognostic factors in the very elderly patients indicated that the completion of adjuvant chemotherapy was the only significant factor. In addition, preoperative albumin level was the only independent risk factor for a failure to complete adjuvant chemotherapy. CONCLUSION: This study demonstrates that the postoperative prognosis in octogenarian patients was not good as that in younger patients possibly due to less frequent completion of adjuvant chemotherapy.

16 Article Reappraisal of Total Pancreatectomy in 45 Patients With Pancreatic Ductal Adenocarcinoma in the Modern Era Using Matched-Pairs Analysis: Multicenter Study Group of Pancreatobiliary Surgery in Japan. 2016

Satoi, Sohei / Murakami, Yoshiaki / Motoi, Fuyuhiko / Sho, Masayuki / Matsumoto, Ippei / Uemura, Kenichiro / Kawai, Manabu / Kurata, Masanao / Yanagimoto, Hiroaki / Yamamoto, Tomohisa / Mizuma, Masamichi / Unno, Michiaki / Kinoshita, Shoichi / Akahori, Takahiro / Shinzeki, Makoto / Fukumoto, Takumi / Hashimoto, Yasushi / Hirono, Seiko / Yamaue, Hiroki / Honda, Goro / Kwon, Masanori. ·From the *Department of Surgery, Kansai Medical University, Osaka; †Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima; ‡Division of Gastroenterological Surgery, Department of Surgery, Tohoku University, Sendai; §Department of Surgery, Nara Medical University, Nara; ∥Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka; ¶Second Department of Surgery, Wakayama Medical University, Wakayama; #Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo; and **Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. ·Pancreas · Pubmed #26692442.

ABSTRACT: OBJECTIVE: The aim of this study was to reappraise the clinical role of total pancreatectomy with curative intent in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: In 2001 to 2011 database from 7 institutions in Japan, 45 (3.1%) of 1451 patients with PDAC underwent total pancreatectomy (TP group), and 885 patients underwent pancreaticoduodenectomy (PD group). A matched-pairs group consisted of 45 patients matched for age, sex, year, resectability status, and neoadjuvant therapy (matched-PD group). Clinicopathological data, overall survival, and disease-free survival were compared between groups. RESULTS: Clinical features of the TP group revealed higher-stage disease, greater surgical stress, a higher frequency of lymph node metastasis, and a lower adjuvant chemotherapy completion rate compared with the PD group (P < 0.05). Overall survival and disease-free survival in the TP group were significantly worse than those in the PD group (P < 0.05). Multivariate analysis revealed resectability status, neoadjuvant therapy, blood transfusion, lymph node metastasis, and adjuvant therapy to be significant prognostic factors. No differences in mortality and morbidity rates were observed between the 2 groups. A matched-pairs analysis revealed similar surgical outcomes and overall survival. CONCLUSIONS: The surgical outcome of total pancreatectomy for patients with PDAC is acceptable. When margin-negative resection is expected, total pancreatectomy should not be abandoned in the modern era.

17 Article Proposed preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after surgical resection: A multi-center retrospective study. 2015

Matsumoto, Ippei / Murakami, Yoshiaki / Shinzeki, Makoto / Asari, Sadaki / Goto, Tadahiro / Tani, Masaji / Motoi, Fuyuhiko / Uemura, Kenichiro / Sho, Masayuki / Satoi, Sohei / Honda, Goro / Yamaue, Hiroki / Unno, Michiaki / Akahori, Takahiro / Kwon, A-Hon / Kurata, Masanao / Ajiki, Tetsuo / Fukumoto, Takumi / Ku, Yonson. ·Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan. Electronic address: ippeimm@gmail.com. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Institute of Biomedical and Health Sciences, Department of Surgery, Hiroshima University, Hiroshima, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Division of Gastroenterological Surgery, Department of Surgery, Tohoku University, Sendai, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Department of Surgery, Nara Medical University, Nara, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Department of Surgery, Kansai Medical University, Hirakata, Japan. · Multicenter Study Group of Pancreatobiliary Surgery (MSG-PBS), Japan; Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. ·Pancreatology · Pubmed #26467797.

ABSTRACT: BACKGROUND/OBJECTIVE: Although surgical resection remains the only chance for cure in patients with pancreatic ductal adenocarcinoma (PDAC), postoperative early recurrence (ER) is frequently encountered. The purpose of this study is to determine the preoperative predictive factors for ER after upfront surgical resection. METHODS: Between 2001 and 2012, 968 patients who underwent upfront surgery with R0 or R1 resection for PDAC at seven high-volume centers in Japan were retrospectively reviewed. ER was defined as relapse within 6 months after surgery. Study analysis stratified by resectable (R) and borderline resectable (BR) PDACs was conducted according to the National Comprehensive Cancer Network guidelines. RESULTS: ER occurred in 239 patients (25%) with a median survival time (MST) of 8.8 months. Modified Glasgow prognostic score = 2 (odds ratio (OR) 2.06, 95% confidence interval (CI) 1.05-3.95; P = 0.044), preoperative CA19-9 ≥300 U/ml (OR 1.94, 1.29-2.90; P = 0.003), and tumor size ≥30 mm (OR 1.72, 1.16-2.56; P = 0.006), were identified as preoperative independent predictive risk factors for ER in patients with R-PDAC. In the R-PDAC patients, MST was 35.5, 26.3, and 15.9 months in patients with 0, 1 and ≥2 risk factors, respectively. There were significant differences in overall survival between the three groups (P < 0.001). No preoperative risk factors were identified in BR-PDAC patients with a high rate of ER (39%). CONCLUSIONS: There is a high-risk subset for ER even in patients with R-PDAC and a simple risk scoring system is useful for prediction of ER.

18 Article Impact of Preoperative Biliary Drainage on Long-Term Survival in Resected Pancreatic Ductal Adenocarcinoma: A Multicenter Observational Study. 2015

Uemura, Kenichiro / Murakami, Yoshiaki / Satoi, Sohei / Sho, Masayuki / Motoi, Fuyuhiko / Kawai, Manabu / Matsumoto, Ippei / Honda, Goro / Kurata, Masanao / Yanagimoto, Hiroaki / Nishiwada, Satoshi / Fukumoto, Takumi / Unno, Michiakil / Yamaue, Hiroki. ·Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. umk@hiroshima-u.ac.jp. · Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. · Department of Surgery, Kansai Medical University, Osaka, Japan. · Department of Surgery, Nara Medical University, Nara, Japan. · Division of Gastroenterological Surgery, Department of Surgery, Tohoku University, Sendai, Japan. · Second Department of Surgery, Wakayama Medical University, Wakayama, Japan. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. ·Ann Surg Oncol · Pubmed #26014151.

ABSTRACT: BACKGROUND: This study aimed to evaluate the impact of preoperative biliary drainage (PBD) on the long-term survival of patients with pancreatic ductal adenocarcinoma (PDAC) who underwent pancreaticoduodenectomy (PD). METHODS: A multicenter observational study was performed using a common database of patients with resected PDAC from seven high-volume surgical institutions in Japan. RESULTS: Of 932 patients who underwent PD for PDAC, 573 (62 %) underwent PBD, including 407 (44 %) who underwent endoscopic biliary drainage (EBD) and 166 (18 %) who underwent percutaneous transhepatic biliary drainage (PTBD). The patients who did not undergo PBD and those who underwent EBD had a significantly better overall survival than those who underwent PTBD, with median survival times of 25.7 months (P < 0.001), 22.3 months (P = 0.001), and 16.7 months, respectively. Multivariate analysis showed that seven clinicopathologic factors, including the use of PTBD but not EBD, were independently associated with poorer overall survival. Furthermore, patients who underwent PTBD more frequently experienced peritoneal recurrence (23 %) than those who underwent EBD (10 %; P < 0.001) and those who did not undergo PBD (11 %; P = 0.001). Multivariate analysis demonstrated that the independent risk factors for peritoneal recurrence included surgical margin status (P < 0.001) and use of PTBD (P = 0.004). CONCLUSIONS: Use of PTBD, but not EBD, was associated with a poorer prognosis, with an increased rate of peritoneal recurrence among patients who underwent PD for PDAC.

19 Article National Comprehensive Cancer Network Resectability Status for Pancreatic Carcinoma Predicts Overall Survival. 2015

Murakami, Yoshiaki / Satoi, Sohei / Sho, Masayuki / Motoi, Fuyuhiko / Matsumoto, Ippei / Kawai, Manabu / Honda, Goro / Uemura, Kenichiro / Yanagimoto, Hiroaki / Shinzeki, Makoto / Kurata, Masanao / Kinoshita, Shoichi / Yamaue, Hiroki / Unno, Michiaki. ·Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan, mura777@hiroshima-u.ac.jp. ·World J Surg · Pubmed #26013206.

ABSTRACT: BACKGROUND: The aim of this study was to evaluate the validity of preoperative resectability status, as defined by the National Comprehensive Cancer Network (NCCN), from the viewpoint of overall survival. METHODS: A total of consecutive 704 patients with pancreatic head carcinoma who underwent pancreatoduodenectomy with upfront surgery at seven Japanese hospitals between 2001 and 2012 were evaluated retrospectively. According to the NCCN definition of preoperative resectability status, tumors were divided into resectable tumors without vascular contact (R group), resectable tumors with portal or superior mesenteric vein (PV/SMV) contact of ≦180° (R-PV group), borderline resectable(BR) tumors with PV/SMV contact of >180° (BR-PV group), and BR tumors with arterial contact (BR-A group). The relationship between the NCCN definition of preoperative resectability status and overall survival was analyzed. RESULTS: Of the 704 patients, 389, 114, 145, and 56 were classified into the R group, the R-PV group, the BR-PV group, and the BR-A group, respectively. Overall survival of the BR-PV and BR-A groups was significantly worse than that of the R group and R-PV groups (P < 0.05), although there was no significant difference in overall survival between the R group and the R-PV group (P = 0.310). Multivariate analysis revealed that PV/SMV contact of >180° (P = 0.008) and arterial contact (P < 0.001) were independent prognostic factors of overall survival. CONCLUSION: From the viewpoint of overall survival, the NCCN definition of preoperative resectability status was valid.

20 Article Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma. 2015

Murakami, Y / Satoi, S / Motoi, F / Sho, M / Kawai, M / Matsumoto, I / Honda, G / Anonymous430827. ·Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. ·Br J Surg · Pubmed #25877050.

ABSTRACT: BACKGROUND: The aim of this study was to determine the added value of portal or superior mesenteric vein (PV/SMV) resection during pancreatoduodenectomy for pancreatic head carcinoma. METHODS: A multicentre observational study was conducted in patients with pancreatic head carcinoma who underwent pancreatoduodenectomy in seven Japanese hospitals between 2001 and 2012. Clinicopathological factors were compared between patients who did and did not undergo PV/SMV resection. Those with an impact on survival were identified by univariable and multivariable analysis. RESULTS: Of the 937 patients who underwent pancreatoduodenectomy, 435 (46·4 per cent) had PV/SMV resection, whereas the remaining 502 (53·6 per cent) did not. Some 71·5 and 63·9 per cent of patients with and without PV/SMV resection respectively had lymph node-positive disease. Patients who underwent PV/SMV resection had more advanced tumours. Perioperative mortality and morbidity rates did not differ between the two groups. Multivariable analysis revealed that PV/SMV resection was not an independent prognostic factor for overall survival (P = 0·268). Among the 435 patients in whom the PV/SMV was resected, borderline resectable tumours with arterial abutment (P = 0·021) and absence of adjuvant chemotherapy (P < 0·001) were independent predictors of poor survival in multivariable analysis. Patients with resectable or borderline resectable tumours with PV/SMV involvement had a median survival time with additional adjuvant chemotherapy of 43·7 and 29·7 months respectively. Median survival time in patients with borderline resectable tumours with arterial abutment was 18·6 months despite adjuvant chemotherapy. CONCLUSION: Pancreatoduodenectomy with PV/SMV resection and adjuvant chemotherapy in patients with pancreatic head carcinoma may provide good survival without increased mortality and morbidity.

21 Article Postoperative prognosis of pancreatic cancer with para-aortic lymph node metastasis: a multicenter study on 822 patients. 2015

Sho, Masayuki / Murakami, Yoshiaki / Motoi, Fuyuhiko / Satoi, Sohei / Matsumoto, Ippei / Kawai, Manabu / Honda, Goro / Uemura, Kenichiro / Yanagimoto, Hiroaki / Kurata, Masanao / Fukumoto, Takumi / Akahori, Takahiro / Kinoshita, Shoichi / Nagai, Minako / Nishiwada, Satoshi / Unno, Michiaki / Yamaue, Hiroki / Nakajima, Yoshiyuki. ·Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan, m-sho@naramed-u.ac.jp. ·J Gastroenterol · Pubmed #25341657.

ABSTRACT: BACKGROUND: The prognosis of pancreatic cancer patients with metastatic para-aortic lymph node (PALN) has been reported to be extremely poor. In general, PALN metastasis has been considered as a contraindication for pancreatic resection. The aim of this study was to reevaluate the postoperative prognostic value of PALN metastasis in pancreatic cancer and to determine the validity of pancreatic surgery. METHODS: Retrospective multicenter analysis of 882 patients who have undergone curative-intent pancreatic resection with pathological evaluation of PALNs for pancreatic ductal adenocarcinoma between 2001 and 2012 was conducted. Clinicopathological data and outcomes were evaluated with univariate and multivariate analysis. RESULTS: In total, 102 (12.4 %) patients had positive metastasis in PALN. Patients with metastatic PALN had significantly poorer survival than those without (17 vs. 23 months; p < 0.001). Multivariable analysis of 822 patients identified adjuvant chemotherapy, primary tumor status, regional lymph node metastasis, portal vein invasion, pre- and post-operative serum CA19-9 levels, and tumor grade as independent prognostic factors. In contrast, PALN metastasis did not have a significant prognostic value. Furthermore, the multivariate prognostic analysis in patients with PALN metastasis revealed that adjuvant chemotherapy and the number of metastatic PALN were significantly associated with long-term survival. Lung metastasis as initial recurrence was observed more often in patients with PALN metastasis in comparison with those without. CONCLUSIONS: Some pancreatic cancer patients with metastatic PALN may survive for longer than expected after pancreatectomy. Adjuvant chemotherapy and the number of metastatic PALN were critical factors for long-term survival of those patients.

22 Article Reappraisal of peritoneal washing cytology in 984 patients with pancreatic ductal adenocarcinoma who underwent margin-negative resection. 2015

Satoi, Sohei / Murakami, Yoshiaki / Motoi, Fuyuhiko / Uemura, Kenichiro / Kawai, Manabu / Kurata, Masanao / Sho, Masayuki / Matsumoto, Ippei / Yanagimoto, Hiroaki / Yamamoto, Tomohisa / Mizuma, Masamichi / Unno, Michiaki / Hashimoto, Yasushi / Hirono, Seiko / Yamaue, Hiroki / Honda, Goro / Nagai, Minako / Nakajima, Yoshiyuki / Shinzeki, Makoto / Fukumoto, Takumi / Kwon, A-Hon. ·Department of Surgery, Kansai Medical University, Osaka, Japan. ·J Gastrointest Surg · Pubmed #25316482.

ABSTRACT: OBJECTIVE: The objective of the present study was to reappraise the clinical value of peritoneal washing cytology (CY) in 984 pancreatic ductal adenocarcinoma patients who underwent margin-negative resection. METHODS: In a 2001-2011 database from seven high-volume surgical institutions in Japan, 69 patients (7%) had positive CY (CY+ group) indicative of M1 disease and 915 patients had negative CY (CY- group). Clinicopathological data and survival were compared between groups. RESULTS: Significant correlations between CY+ and high CA19-9 level, pancreatic body and tail cancer, lymph node metastasis, and a lower frequency of R0 resection were observed. Overall survival (OS) of CY+ patients was significantly worse than that of CY- patients (median survival time [MST], 16 vs. 25 months; 3-year OS rate, 6 vs. 37%; p < 0.001). CY+ patients had a significantly higher rate of post-operative peritoneal carcinomatosis than CY- patients (48 vs. 21%; p < 0.001). Administration of adjuvant chemotherapy did not provide a favorable survival outcome to CY+ patients. The current study showed that patients with M1 disease had acceptable MST after margin-negative resection and a high incidence of peritoneal carcinomatosis within 3 years after surgery, resulting in decreased long-term survival. The development of a new strategy to control peritoneal carcinomatosis when surgical resection is performed in such patients is required.

23 Article Case-control study of diabetes-related genetic variants and pancreatic cancer risk in Japan. 2014

Kuruma, Sawako / Egawa, Naoto / Kurata, Masanao / Honda, Goro / Kamisawa, Terumi / Ueda, Junko / Ishii, Hiroshi / Ueno, Makoto / Nakao, Haruhisa / Mori, Mitsuru / Matsuo, Keitaro / Hosono, Satoyo / Ohkawa, Shinichi / Wakai, Kenji / Nakamura, Kozue / Tamakoshi, Akiko / Nojima, Masanori / Takahashi, Mami / Shimada, Kazuaki / Nishiyama, Takeshi / Kikuchi, Shogo / Lin, Yingsong. ·Sawako Kuruma, Terumi Kamisawa, Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo 113-8677, Japan. ·World J Gastroenterol · Pubmed #25516658.

ABSTRACT: AIM: To examine whether diabetes-related genetic variants are associated with pancreatic cancer risk. METHODS: We genotyped 7 single-nucleotide polymorphisms (SNPs) in PPARG2 (rs1801282), ADIPOQ (rs1501299), ADRB3 (rs4994), KCNQ1 (rs2237895), KCNJ11 (rs5219), TCF7L2 (rs7903146), and CDKAL1 (rs2206734), and examined their associations with pancreatic cancer risk in a multi-institute case-control study including 360 cases and 400 controls in Japan. A self-administered questionnaire was used to collect detailed information on lifestyle factors. Genotyping was performed using Fluidigm SNPtype assays. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between these diabetes-associated variants and pancreatic cancer risk. RESULTS: With the exception of rs1501299 in the ADIPOQ gene (P = 0.09), no apparent differences in genotype frequencies were observed between cases and controls. Rs1501299 in the ADPIOQ gene was positively associated with pancreatic cancer risk; compared with individuals with the AA genotype, the age- and sex-adjusted OR was 1.79 (95%CI: 0.98-3.25) among those with the AC genotype and 1.86 (95%CI: 1.03-3.38) among those with the CC genotype. The ORs remained similar after additional adjustment for body mass index and cigarette smoking. In contrast, rs2237895 in the KCNQ1 gene was inversely related to pancreatic cancer risk, with a multivariable-adjusted OR of 0.62 (0.37-1.04) among individuals with the CC genotype compared with the AA genotype. No significant associations were noted for other 5 SNPs. CONCLUSION: Our case-control study indicates that rs1501299 in the ADIPOQ gene may be associated with pancreatic cancer risk. These findings should be replicated in additional studies.

24 Article Influence of preoperative anti-cancer therapy on resectability and perioperative outcomes in patients with pancreatic cancer: project study by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. 2014

Motoi, Fuyuhiko / Unno, Michiaki / Takahashi, Hidenori / Okada, Takaho / Wada, Keita / Sho, Masayuki / Nagano, Hiroaki / Matsumoto, Ippei / Satoi, Sohei / Murakami, Yoshiaki / Kishiwada, Masashi / Honda, Goro / Kinoshita, Hisafumi / Baba, Hideo / Hishinuma, Shoichi / Kitago, Minoru / Tajima, Hidehiro / Shinchi, Hiroyuki / Takamori, Hiroshi / Kosuge, Tomoo / Yamaue, Hiroki / Takada, Tadahiro. ·Division of Gastroenterological Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. ·J Hepatobiliary Pancreat Sci · Pubmed #23913634.

ABSTRACT: BACKGROUND: Little is known about the effects of neoadjuvant therapy on outcomes in patients with pancreatic cancer. This study evaluated the effects of neoadjuvant therapy on resectability and perioperative outcomes. METHODS: A total of 992 patients were enrolled, with 971 deemed eligible. Of these, 582 had resectable tumors and 389 had borderline resectable tumors, and 388 patients received neoadjuvant therapy. Demographic characteristics and peri- and postoperative parameters were assessed by a questionnaire survey. RESULTS: The R0 rate was significantly higher in patients with resectable tumors who received neoadjuvant therapy than in those who underwent surgery first, but no significant difference was noted in patients with borderline resectable tumors. Operation time was significantly longer and blood loss was significantly greater in patients who received neoadjuvant therapy than in those who underwent surgery first, but there were no significant differences in specific complications and mortality rates. The node positivity rate was significantly lower in the neoadjuvant than in the surgery-first group, indicating that the former had significantly lower stage tumors. CONCLUSIONS: Neoadjuvant therapy may not increase the mortality and morbidity rate and may be able to increase the chance for curative resection against resectable tumor.

25 Article Laparoscopic pancreaticoduodenectomy: taking advantage of the unique view from the caudal side. 2013

Honda, Goro / Kurata, Masanao / Okuda, Yukihiro / Kobayashi, Shin / Sakamoto, Katsunori / Takahashi, Keiichi. ·Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan. Electronic address: ghon@cick.jp. ·J Am Coll Surg · Pubmed #24051066.

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