Invited Critique |

Preoperative Chemotherapy, Radiotherapy, and Surgical Resection of Locally Advanced Pancreatic Cancer—Invited Critique

Christian Herfarth, MD
Arch Surg. 2000;135(1):88. doi:10.1001/archsurg.135.1.88.
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A prospective uncontrolled study on preoperative chemoradiotherapy in patients with locally advanced pancreatic cancer is presented. The neoadjuvant therapeutic regimen consisted of fluorouracil, 400 mg/m2, and cisplatin, 25 mg/m2, along with concurrent radiation of 45 Gy. Patients were surgically staged prior to the neoadjuvant regimen and had biliary along with gastric bypass as well as a feeding jejunostomy tube placed. Of 14 patients, 11 underwent reexploration. Two of these 11 patients had progressive disease that was unresectable; 9 had definitive resections, 6 of whom had either portal vein or major arterial resections. There was 1 hospital death and 1 long-term survivor (>96 months). Median survival was 16 months after definitive surgery.

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