Significance of non-surgical treatment in the management of locally advanced pancreatic cancer

Abstract

In recent years, prognosis of patients with unresectable locally advanced pancreatic cancer (LAPC) has improved because of improvements in chemoradiotherapy (CRT) or chemotherapy. Several clinical studies on CRT or chemotherapy have shown favorable efficacy with median survival more than 15 months. In addition, some studies have reported the use of CRT or chemotherapy to convert unresectable disease to resectable status in patients with LAPC. However, there is still limited evidence for the treatment of LAPC, and the role of CRT remains controversial. In this report, we reviewed the outcome of CRT in our facilities, and considered the significance of non-surgical treatment for LAPC. The median survival time was 15.4 months, and 3-year and 5-year survival rate were 17.5% and 6.7%, respectively. There were some long-term survivors after CRT in our cohort of patients. In this report, we also reviewed the outcome of surgery after CRT or chemotherapy in patients with LAPC, and considered the significance of such multidisciplinary approach to improve patient outcome.