Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease
Background Patients with locally unresectable pancreatic cancer (AJCC stage III) have a median survival of 10–14 months. The objective of this study was to evaluate outcome of initially unresectable patients who respond to multimodality therapy and undergo resection. Methods Using a prospectively co...
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| Veröffentlicht in: | Annals of surgical oncology 2012-05, Vol.19 (5), p.1663-1669 |
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| creator | Bickenbach, K. A. Gonen, M. Tang, Laura H. O’Reilly, Eileen Goodman, Karyn Brennan, M. F. D’Angelica, M. I. DeMatteo, R. P. Fong, Y. Jarnagin, W. R. Allen, P. J. |
| description | Background
Patients with locally unresectable pancreatic cancer (AJCC stage III) have a median survival of 10–14 months. The objective of this study was to evaluate outcome of initially unresectable patients who respond to multimodality therapy and undergo resection.
Methods
Using a prospectively collected database, patients were identified who were initially unresectable because of vascular invasion and had sufficient response to nonoperative treatment to undergo resection. Overall survival (OS) was compared with a matched group of patients who were initially resectable. Case matching was performed using a previously validated pancreatic cancer nomogram.
Results
A total of 36 patients with initial stage III disease were identified who underwent resection after treatment with either systemic therapy or chemoradiation. Initial unresectability was determined by operative exploration (
n
= 15, 42%) or by cross-sectional imaging (
n
= 21, 58%). Resection consisted of pancreaticoduodenectomy (
n
= 31, 86%), distal pancreatectomy (
n
= 4, 11%), and total pancreatectomy (
n
= 1, 3%). Pathology revealed T3 lesions in 26 patients (73%), node positivity in 6 patients (16%), and a negative margin in 30 patients (83%). The median OS in this series was 25 months from resection and 30 months since treatment initiation. There was no difference in OS from time of resection between the initial stage III patients and those who presented with resectable disease (
P
= .35).
Conclusions
In this study, patients who were able to undergo resection following treatment of initial stage III pancreatic cancer experienced survival similar to those who were initially resectable. Resection is indicated in this highly select group of patients. |
| doi_str_mv | 10.1245/s10434-011-2156-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8482836</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2660378121</sourcerecordid><originalsourceid>FETCH-LOGICAL-c536t-47295ccd7cbb3790c026e1fec13ca2b4a3fda2558779cdc0a4db79dd72c795d93</originalsourceid><addsrcrecordid>eNp1kctOHDEQRa0oUXgkH8AGWcq6id_uZoE0GiBBmgiUwNpy2-7BqMcmtgc0f8Enx80QRBZZVcl176mSLwAHGB1hwvjXjBGjrEEYNwRz0ch3YBfz-sJEi9_XHom26YjgO2Av5zuEsKSIfwQ7hGCKBMG74Ok0PoZc9NKHJfQBXulgktPFGzivrUvHcAZ_6GJunYWzoMdN9hnGoQqLd6Fk-NNlZ0qdnsdxjI8T59cmF7eqiOsJtaqyyXERfPF6HDdwEc1zvQnp2az70cFTn53O7hP4MOgxu88vdR_cnJ9dz783i8tvF_PZojGcitIwSTpujJWm76nskEFEODw4g6nRpGeaDlYTzlspO2MN0sz2srNWEiM7bju6D0623Pt1v3LW1COTHtV98iudNipqr_6dBH-rlvFBtawlLRUV8OUFkOLvtctF3cV1qj-UFUaYMkE4m9bgrcqkmHNyw-sGjNQUotqGqGqIagpRyeo5fHvaq-NvalVAtoJcR2Hp0tvV_6P-ARZ5qy8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1013462549</pqid></control><display><type>article</type><title>Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Bickenbach, K. A. ; Gonen, M. ; Tang, Laura H. ; O’Reilly, Eileen ; Goodman, Karyn ; Brennan, M. F. ; D’Angelica, M. I. ; DeMatteo, R. P. ; Fong, Y. ; Jarnagin, W. R. ; Allen, P. J.</creator><creatorcontrib>Bickenbach, K. A. ; Gonen, M. ; Tang, Laura H. ; O’Reilly, Eileen ; Goodman, Karyn ; Brennan, M. F. ; D’Angelica, M. I. ; DeMatteo, R. P. ; Fong, Y. ; Jarnagin, W. R. ; Allen, P. J.</creatorcontrib><description>Background
Patients with locally unresectable pancreatic cancer (AJCC stage III) have a median survival of 10–14 months. The objective of this study was to evaluate outcome of initially unresectable patients who respond to multimodality therapy and undergo resection.
Methods
Using a prospectively collected database, patients were identified who were initially unresectable because of vascular invasion and had sufficient response to nonoperative treatment to undergo resection. Overall survival (OS) was compared with a matched group of patients who were initially resectable. Case matching was performed using a previously validated pancreatic cancer nomogram.
Results
A total of 36 patients with initial stage III disease were identified who underwent resection after treatment with either systemic therapy or chemoradiation. Initial unresectability was determined by operative exploration (
n
= 15, 42%) or by cross-sectional imaging (
n
= 21, 58%). Resection consisted of pancreaticoduodenectomy (
n
= 31, 86%), distal pancreatectomy (
n
= 4, 11%), and total pancreatectomy (
n
= 1, 3%). Pathology revealed T3 lesions in 26 patients (73%), node positivity in 6 patients (16%), and a negative margin in 30 patients (83%). The median OS in this series was 25 months from resection and 30 months since treatment initiation. There was no difference in OS from time of resection between the initial stage III patients and those who presented with resectable disease (
P
= .35).
Conclusions
In this study, patients who were able to undergo resection following treatment of initial stage III pancreatic cancer experienced survival similar to those who were initially resectable. Resection is indicated in this highly select group of patients.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-011-2156-7</identifier><identifier>PMID: 22130621</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject><![CDATA[Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - secondary ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Capecitabine ; Case-Control Studies ; Chemoradiotherapy ; Cisplatin - administration & dosage ; Cohort Studies ; Combined Modality Therapy ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Erlotinib Hydrochloride ; Female ; Fluorouracil - administration & dosage ; Fluorouracil - analogs & derivatives ; Humans ; Length of Stay ; Leucovorin - administration & dosage ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Oncology ; Pancreatic cancer ; Pancreatic Neoplasms - mortality ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - therapy ; Pancreatic Tumors ; Pancreaticoduodenectomy ; Quinazolines - administration & dosage ; Surgery ; Surgical Oncology ; Survival Rate ; Taxoids - administration & dosage]]></subject><ispartof>Annals of surgical oncology, 2012-05, Vol.19 (5), p.1663-1669</ispartof><rights>Society of Surgical Oncology 2011</rights><rights>Society of Surgical Oncology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-47295ccd7cbb3790c026e1fec13ca2b4a3fda2558779cdc0a4db79dd72c795d93</citedby><cites>FETCH-LOGICAL-c536t-47295ccd7cbb3790c026e1fec13ca2b4a3fda2558779cdc0a4db79dd72c795d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-011-2156-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-011-2156-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22130621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bickenbach, K. A.</creatorcontrib><creatorcontrib>Gonen, M.</creatorcontrib><creatorcontrib>Tang, Laura H.</creatorcontrib><creatorcontrib>O’Reilly, Eileen</creatorcontrib><creatorcontrib>Goodman, Karyn</creatorcontrib><creatorcontrib>Brennan, M. F.</creatorcontrib><creatorcontrib>D’Angelica, M. I.</creatorcontrib><creatorcontrib>DeMatteo, R. P.</creatorcontrib><creatorcontrib>Fong, Y.</creatorcontrib><creatorcontrib>Jarnagin, W. R.</creatorcontrib><creatorcontrib>Allen, P. J.</creatorcontrib><title>Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Patients with locally unresectable pancreatic cancer (AJCC stage III) have a median survival of 10–14 months. The objective of this study was to evaluate outcome of initially unresectable patients who respond to multimodality therapy and undergo resection.
Methods
Using a prospectively collected database, patients were identified who were initially unresectable because of vascular invasion and had sufficient response to nonoperative treatment to undergo resection. Overall survival (OS) was compared with a matched group of patients who were initially resectable. Case matching was performed using a previously validated pancreatic cancer nomogram.
Results
A total of 36 patients with initial stage III disease were identified who underwent resection after treatment with either systemic therapy or chemoradiation. Initial unresectability was determined by operative exploration (
n
= 15, 42%) or by cross-sectional imaging (
n
= 21, 58%). Resection consisted of pancreaticoduodenectomy (
n
= 31, 86%), distal pancreatectomy (
n
= 4, 11%), and total pancreatectomy (
n
= 1, 3%). Pathology revealed T3 lesions in 26 patients (73%), node positivity in 6 patients (16%), and a negative margin in 30 patients (83%). The median OS in this series was 25 months from resection and 30 months since treatment initiation. There was no difference in OS from time of resection between the initial stage III patients and those who presented with resectable disease (
P
= .35).
Conclusions
In this study, patients who were able to undergo resection following treatment of initial stage III pancreatic cancer experienced survival similar to those who were initially resectable. Resection is indicated in this highly select group of patients.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - secondary</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Capecitabine</subject><subject>Case-Control Studies</subject><subject>Chemoradiotherapy</subject><subject>Cisplatin - administration & dosage</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Erlotinib Hydrochloride</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Fluorouracil - analogs & derivatives</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Leucovorin - administration & dosage</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - mortality</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Pancreatic Tumors</subject><subject>Pancreaticoduodenectomy</subject><subject>Quinazolines - administration & dosage</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Taxoids - administration & dosage</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kctOHDEQRa0oUXgkH8AGWcq6id_uZoE0GiBBmgiUwNpy2-7BqMcmtgc0f8Enx80QRBZZVcl176mSLwAHGB1hwvjXjBGjrEEYNwRz0ch3YBfz-sJEi9_XHom26YjgO2Av5zuEsKSIfwQ7hGCKBMG74Ok0PoZc9NKHJfQBXulgktPFGzivrUvHcAZ_6GJunYWzoMdN9hnGoQqLd6Fk-NNlZ0qdnsdxjI8T59cmF7eqiOsJtaqyyXERfPF6HDdwEc1zvQnp2az70cFTn53O7hP4MOgxu88vdR_cnJ9dz783i8tvF_PZojGcitIwSTpujJWm76nskEFEODw4g6nRpGeaDlYTzlspO2MN0sz2srNWEiM7bju6D0623Pt1v3LW1COTHtV98iudNipqr_6dBH-rlvFBtawlLRUV8OUFkOLvtctF3cV1qj-UFUaYMkE4m9bgrcqkmHNyw-sGjNQUotqGqGqIagpRyeo5fHvaq-NvalVAtoJcR2Hp0tvV_6P-ARZ5qy8</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Bickenbach, K. A.</creator><creator>Gonen, M.</creator><creator>Tang, Laura H.</creator><creator>O’Reilly, Eileen</creator><creator>Goodman, Karyn</creator><creator>Brennan, M. F.</creator><creator>D’Angelica, M. I.</creator><creator>DeMatteo, R. P.</creator><creator>Fong, Y.</creator><creator>Jarnagin, W. R.</creator><creator>Allen, P. J.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20120501</creationdate><title>Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease</title><author>Bickenbach, K. A. ; Gonen, M. ; Tang, Laura H. ; O’Reilly, Eileen ; Goodman, Karyn ; Brennan, M. F. ; D’Angelica, M. I. ; DeMatteo, R. P. ; Fong, Y. ; Jarnagin, W. R. ; Allen, P. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-47295ccd7cbb3790c026e1fec13ca2b4a3fda2558779cdc0a4db79dd72c795d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - secondary</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Capecitabine</topic><topic>Case-Control Studies</topic><topic>Chemoradiotherapy</topic><topic>Cisplatin - administration & dosage</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Erlotinib Hydrochloride</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Fluorouracil - analogs & derivatives</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Leucovorin - administration & dosage</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - mortality</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - therapy</topic><topic>Pancreatic Tumors</topic><topic>Pancreaticoduodenectomy</topic><topic>Quinazolines - administration & dosage</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Taxoids - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bickenbach, K. A.</creatorcontrib><creatorcontrib>Gonen, M.</creatorcontrib><creatorcontrib>Tang, Laura H.</creatorcontrib><creatorcontrib>O’Reilly, Eileen</creatorcontrib><creatorcontrib>Goodman, Karyn</creatorcontrib><creatorcontrib>Brennan, M. F.</creatorcontrib><creatorcontrib>D’Angelica, M. I.</creatorcontrib><creatorcontrib>DeMatteo, R. P.</creatorcontrib><creatorcontrib>Fong, Y.</creatorcontrib><creatorcontrib>Jarnagin, W. R.</creatorcontrib><creatorcontrib>Allen, P. J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bickenbach, K. A.</au><au>Gonen, M.</au><au>Tang, Laura H.</au><au>O’Reilly, Eileen</au><au>Goodman, Karyn</au><au>Brennan, M. F.</au><au>D’Angelica, M. I.</au><au>DeMatteo, R. P.</au><au>Fong, Y.</au><au>Jarnagin, W. R.</au><au>Allen, P. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>19</volume><issue>5</issue><spage>1663</spage><epage>1669</epage><pages>1663-1669</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Patients with locally unresectable pancreatic cancer (AJCC stage III) have a median survival of 10–14 months. The objective of this study was to evaluate outcome of initially unresectable patients who respond to multimodality therapy and undergo resection.
Methods
Using a prospectively collected database, patients were identified who were initially unresectable because of vascular invasion and had sufficient response to nonoperative treatment to undergo resection. Overall survival (OS) was compared with a matched group of patients who were initially resectable. Case matching was performed using a previously validated pancreatic cancer nomogram.
Results
A total of 36 patients with initial stage III disease were identified who underwent resection after treatment with either systemic therapy or chemoradiation. Initial unresectability was determined by operative exploration (
n
= 15, 42%) or by cross-sectional imaging (
n
= 21, 58%). Resection consisted of pancreaticoduodenectomy (
n
= 31, 86%), distal pancreatectomy (
n
= 4, 11%), and total pancreatectomy (
n
= 1, 3%). Pathology revealed T3 lesions in 26 patients (73%), node positivity in 6 patients (16%), and a negative margin in 30 patients (83%). The median OS in this series was 25 months from resection and 30 months since treatment initiation. There was no difference in OS from time of resection between the initial stage III patients and those who presented with resectable disease (
P
= .35).
Conclusions
In this study, patients who were able to undergo resection following treatment of initial stage III pancreatic cancer experienced survival similar to those who were initially resectable. Resection is indicated in this highly select group of patients.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22130621</pmid><doi>10.1245/s10434-011-2156-7</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2012-05, Vol.19 (5), p.1663-1669 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8482836 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - secondary Adenocarcinoma - therapy Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Capecitabine Case-Control Studies Chemoradiotherapy Cisplatin - administration & dosage Cohort Studies Combined Modality Therapy Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Erlotinib Hydrochloride Female Fluorouracil - administration & dosage Fluorouracil - analogs & derivatives Humans Length of Stay Leucovorin - administration & dosage Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Oncology Pancreatic cancer Pancreatic Neoplasms - mortality Pancreatic Neoplasms - pathology Pancreatic Neoplasms - therapy Pancreatic Tumors Pancreaticoduodenectomy Quinazolines - administration & dosage Surgery Surgical Oncology Survival Rate Taxoids - administration & dosage |
| title | Downstaging in Pancreatic Cancer: A Matched Analysis of Patients Resected Following Systemic Treatment of Initially Locally Unresectable Disease |
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