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Relationship Between Surgical R0 Resectability and Findings of Peripancreatic Vascular Invasion on CT Imaging After Neoadjuvant S-1 and Concurrent Radiotherapy in Patients with Borderline Resectable Pancreatic Cancer
Tatsushi Kobayashi
Kokuritsu Gan Center Higashi Byoin
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background
Borderline resectable pancreatic cancer (BRPC) is frequently associated with positive surgical margins and a poor prognosis because the tumor is in contact with major vessels. This study evaluated the relationship between the margin-negative (R0) resection rate and findings indicating peripancreatic vascular invasion on multidetector computed tomography (MDCT) imaging after neoadjuvant chemoradiotherapy (NACRT) in patients with BRPC.
Methods
Twenty-nine BRPC patients who underwent laparotomy after neoadjuvant S-1 with concurrent radiotherapy were studied retrospectively. Peripancreatic major vessel invasion was evaluated based on the length of tumor-vessel contact on MDCT. The R0 resection rates were compared between the progression of vascular invasion (PVI) group and the non-progression of vascular invasion (NVI) group.
Results
There were 3 patients with partial responses (10%), 25 with stable disease (86%), and 1 with progressive disease (3%) according to the RECISTv1.1 criteria. Regarding vascular invasion, 9 patients (31%) were classified as having PVI, and 20 patients (69%) were classified as having NVI. Of the 29 patients, 27 (93%) received an R0 resection, and all the PVI patients received an R0 resection (9/9; R0 resection rate = 100%). The R0 resection rates did not differ significantly between the PVI and NVI groups (P = 1.000, 100% vs. 90%).
Conclusions
Patients with BRPC after NACRT achieved high R0 resection rates regardless of the vascular invasion status. BRPC patients can undergo R0 resections unless progressive disease is observed after NACRT.
Trial registration
UMIN-CTR, UMIN000009172. Registered 23 October 2012, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000010762
Keywords
Borderline resectable pancreatic cancer, Neoadjuvant chemoradiotherapy, S-1 and concurrent radiotherapy, Progression of vascular invasion, R0 resectability, JASPAC 05
Figure 1
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CURRENT STATUS: Published
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Posted 08 Nov, 2020
Reviewer #2 agreed
On 08 Nov, 2020
Editor assigned
On 08 Nov, 2020
Reviewers invited
Invitations sent on 08 Nov, 2020
Reviewer #1 agreed
On 08 Nov, 2020
Review #1 received
Received 08 Nov, 2020
Review #2 received
Received 08 Nov, 2020
Submission checks complete
On 08 Nov, 2020
Editor invited
On 08 Nov, 2020
This version was not preprinted
Version 1
Posted 15 Sep, 2020
Published
On 02 Dec, 2020
Published
On 02 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 13 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewer #2 agreed
On 05 Oct, 2020
Editor assigned
On 14 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Submission checks complete
On 11 Sep, 2020
Editor invited
On 10 Sep, 2020
First submitted
On 25 Aug, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Relationship Between Surgical R0 Resectability and Findings of Peripancreatic Vascular Invasion on CT Imaging After Neoadjuvant S-1 and Concurrent Radiotherapy in Patients with Borderline Resectable Pancreatic Cancer
Tatsushi Kobayashi
Kokuritsu Gan Center Higashi Byoin
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version (no preprint)
Posted 08 Nov, 2020
Reviewer #2 agreed
On 08 Nov, 2020
Editor assigned
On 08 Nov, 2020
Reviewers invited
Invitations sent on 08 Nov, 2020
Reviewer #1 agreed
On 08 Nov, 2020
Review #1 received
Received 08 Nov, 2020
Review #2 received
Received 08 Nov, 2020
Submission checks complete
On 08 Nov, 2020
Editor invited
On 08 Nov, 2020
This version was not preprinted
Version 1
Posted 15 Sep, 2020
Published
On 02 Dec, 2020
Published
On 02 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 13 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewer #2 agreed
On 05 Oct, 2020
Editor assigned
On 14 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Submission checks complete
On 11 Sep, 2020
Editor invited
On 10 Sep, 2020
First submitted
On 25 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background
Borderline resectable pancreatic cancer (BRPC) is frequently associated with positive surgical margins and a poor prognosis because the tumor is in contact with major vessels. This study evaluated the relationship between the margin-negative (R0) resection rate and findings indicating peripancreatic vascular invasion on multidetector computed tomography (MDCT) imaging after neoadjuvant chemoradiotherapy (NACRT) in patients with BRPC.
Methods
Twenty-nine BRPC patients who underwent laparotomy after neoadjuvant S-1 with concurrent radiotherapy were studied retrospectively. Peripancreatic major vessel invasion was evaluated based on the length of tumor-vessel contact on MDCT. The R0 resection rates were compared between the progression of vascular invasion (PVI) group and the non-progression of vascular invasion (NVI) group.
Results
There were 3 patients with partial responses (10%), 25 with stable disease (86%), and 1 with progressive disease (3%) according to the RECISTv1.1 criteria. Regarding vascular invasion, 9 patients (31%) were classified as having PVI, and 20 patients (69%) were classified as having NVI. Of the 29 patients, 27 (93%) received an R0 resection, and all the PVI patients received an R0 resection (9/9; R0 resection rate = 100%). The R0 resection rates did not differ significantly between the PVI and NVI groups (P = 1.000, 100% vs. 90%).
Conclusions
Patients with BRPC after NACRT achieved high R0 resection rates regardless of the vascular invasion status. BRPC patients can undergo R0 resections unless progressive disease is observed after NACRT.
Trial registration
UMIN-CTR, UMIN000009172. Registered 23 October 2012, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000010762
Figure 1