Ergebnisse der chirurgischen Therapie beim lokal fortgeschrittenen Pankreascarcinom nach präoperativer Radio-Chemotherapie

Abstract

Background: In pancreatic cancer surgical resection is the only prospect for cure, nonetheless most patients have advanced non-resectable disease at the time of diagnosis. Neoadjuvant pre-operative chemo-radiation has been introduced to improve local resectability and long-term survival in these patients. This study evaluates the results of neoadjuvant radio-chemotherapy with gemcitabine and 5-fluorouracil (5-FU) or cisplatin. Materials and Methods: A total of 26 patients with locally advanced pancreatic cancer were treated with sequential gemcitabine and 5-FU (n = 16) or simultaneous gemcitabine and cisplatin (n = 10) prior to surgical therapy. Results: The mean patient age was 62 years and 62% (n = 16) were male. Pre-operative tumor reduction was achieved in 77% and in 9 of 17 patients who underwent surgery resection for cure was performed. Median survival of all patients was 9.8 months after primary cancer diagnosis. To date, curative surgical therapy has not resulted in significantly better survival compared to patients without resection for cure after chemo-radiation. Conclusions: Neoadjuvant radio-chemotherapy with gemcitabine and 5-FU or cisplatin is an important pre-operative therapeutic tool in patients with locally advanced pancreatic cancer. The prognostic relevance of surgical tumor resection after neoadjuvant chemo-radiation remains to be determined.