Arterial involvement and resectability scoring system to predict R0 resection in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation therapy

2021 ◽  
Author(s):  
Yoshifumi Noda ◽  
Nisanard Pisuchpen ◽  
Nathaniel D. Mercaldo ◽  
Yurie Sekigami ◽  
Theodoros Michelakos ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Scoring System ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
Ductal Adenocarcinoma ◽  
R0 Resection ◽  
Neoadjuvant Chemoradiation Therapy ◽  
Arterial Involvement

scholarly journals The spectrum of histopathological changes encountered in pancreatectomy specimens after neoadjuvant chemoradiation, including subtle and less-well-recognised changes

2016 ◽  
Vol 69 (6) ◽  
pp. 463-471 ◽  
Author(s):  
Sangeetha N Kalimuthu ◽  
Stefano Serra ◽  
Neesha Dhani ◽  
Runjan Chetty
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Treatment Modality ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
Ductal Adenocarcinoma ◽  
Histopathological Changes ◽  
Borderline Resectable ◽  
Histological Changes ◽  
Histological Features ◽  
Therapy Treatment

Preoperative (neoadjuvant) chemoradiation therapy/treatment (NCRT) is emerging as an important treatment modality in borderline resectable pancreatic ductal adenocarcinoma (PDAC). The constellation of histopathological changes secondary to chemoradiation is diverse and has been well documented, particularly in other gastrointestinal organs such as the oesophagus and colorectum. However, the histological changes specific to the pancreas have not been fully characterised and described. This review aims to provide a detailed catalogue of histological features associated with NCRT-treated PDAC and highlight any subtle, less-recognised changes.

Neoadjuvant chemoradiation therapy for cholangiocarcinoma to improve R0 resection rate: The first report of phase II study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 402-402 ◽  
Author(s):  
Yu Katayose ◽  
Kei Nakagawa ◽  
Hiroshi Yoshida ◽  
Takanori Morikawa ◽  
Hiroki Hayashi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Phase Ii ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
External Beam Radiation ◽  
R0 Resection ◽  
Resection Rate ◽  
Beam Radiation ◽  
Term Survival ◽  
Neoadjuvant Chemoradiation Therapy

402 Background: With the much-improved surgical techniques of hepatic lobectomy, but the long-term survival of patients undergoing such surgery remains far from satisfactory. Then, to improve the prognosis of cholangiocarcinoma patients, we have applied neoadjuvant chemoradiation therapy followed by conventional resection for possibly resectable cholangiocarcinoma, named NACRAC. Here, we analyzed and evaluated the Phase II (P-2) study. Methods: Patients with histologically or cytologically confirmed adenocarcinoma of the extra- and hilar cholangiocarcinoma were enrolled from 2008 to 2013 at Department Surgery, Tohoku University Hospital. The dose of gemcitabine was determined 600mg/m2 of gemcitabine with external beam radiation therapy (1.8-Gy daily fractions to a total dose of 45 Gy) ( Hepatogastroenterology. 2011;58(112):1866-72.). The primary endpoint of P-2 is R0-resection rate. We hypothesized that R0-resection rate become from 60% to 80%. Results: Total numbers of enrolled patients were 25 cases. 22 cases were operated, and 20 cases were resected. After chemoradiation, 3 cases were not operated by liver metastases, tumor progression, and heart failure. 2 cases were not resected by peritoneal carcinomatosis. One case was diagnosed as pancreatic cancer at the final pathological diagnosis. R0-resectinn cases were 17 cases. R0 resection rate was 89.6% (17/19) among operated cases. In recruited 24 cases (A pancreatic cancer was not included), R0 resection rate was 70.8% (17/24). Grade 3 and 4 adverse events (AE) were neutropenia, leukocytopenia, and Thrombocytopenia. No grade 5 AE and no fatal AE in this P-2 study. Conclusions: Neoadjuvant chemoradiation therapy with conventional resections appears to be effective and well tolerated. After both disease free survival and overall survival are going to be fixed, we will decide a proper indication of neoadjuvant therapy for cholangiocarcinoma. Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) UMIN UMIN000000992 and UMIN000001754 Clinical trial information: 000001754.

Effects of Neoadjuvant Chemio-Radiation Therapy on the Anal Sphincter Function in Patients with Low Rectal Cancers

2020 ◽  
Vol 10 (3) ◽  
pp. 190-197
Author(s):  
A. B. Baichorov ◽  
A. O. Rasulov
Keyword(s):  
Anal Sphincter ◽  
Neoadjuvant Chemoradiotherapy ◽  
Functional Results ◽  
Neoadjuvant Chemoradiation ◽  
Chemoradiation Therapy ◽  
Preoperative Treatment ◽  
Neoadjuvant Chemoradiation Therapy ◽  
Reconstruction Methods ◽  
Anterior Rectal Resection ◽  
Significant Difference

The aim of the study was to compare functional results prior to and following neoadjuvant chemoradiation therapy.Materials and methods. An analysis of the functional results of a prospective clinical study was carried out. The study included 90 patients who underwent low anterior rectal resection for cancer of the lower or middle ampullar rectum with T1-4aN0-2M0 using various reconstruction methods.Results and discussion. Group A included 22 patients with J-shaped reservoirs; group B — 30 patients with side-to-end anastomoses; group C — 38 patients with end-to-end anastomoses. Out of the total study group (n = 90), 43 patients underwent neoadjuvant chemoradiotherapy vs. 47 patients without any preoperative treatment. No statistically significant difference was observed in the frequency of applied reconstructive techniques (р = 0.725) and the incidence of postoperative complications (p = 0.103) in the groups with and without neoadjuvant chemoradiotherapy. The baseline scores of the Wexner scale and the results of anorectal manometry in the comparison groups were comparable (p > 0.05). However, upon completion of neoadjuvant chemoradiotherapy and during the period from the moment of surgery up to 12 months after the closure of preventive intestinal stomas, the functional results were less satisfactory in the group of patients having received neoadjuvant chemoradiotherapy (n = 43) with regard to the comparison group (n =  47). Nevertheless, a statistically significant difference in the results was observed from the end of neoadjuvant chemoradiotherapy up to 3 months after closure of the stoma (p <0.05).Conclusions. Neoadjuvant chemoradiation therapy has a negative effect on the function of the anal sphincter, thus requiring concomitant therapy and physiotherapy both at the stages of neoadjuvant chemoradiotherapy and at long intervals after the main surgical stage. 

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