Covered self‐expandable metal stent deployment promises safe neoadjuvant chemoradiation therapy in patients with borderline resectable pancreatic head cancer

Abstract

CSEMS should be considered to relieve symptomatic biliary obstruction in patients with BRPHC receiving NACRT in view of the high attainability rate of safe R0 surgery compared to that with PS deployment.

Preoperative Biliary Drainage in Cases of Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgery

“…There have been almost no studies of the one drawback associated with the use of MS in PBD procedures: its cost. In their investigation of the cost from the start of PBD until surgery, Kubota et al reported that the use of PS in PBD procedures cost USD 11,545 and that the use of MS cost USD 11,773, indicating no significant difference between the two [ 27 ]. A simulation of individual cases revealed that PS placement with two or more reinterventions was more effective than a single MS placement [ 27 ].…”

“…In their investigation of the cost from the start of PBD until surgery, Kubota et al reported that the use of PS in PBD procedures cost USD 11,545 and that the use of MS cost USD 11,773, indicating no significant difference between the two [ 27 ]. A simulation of individual cases revealed that PS placement with two or more reinterventions was more effective than a single MS placement [ 27 ]. Our study also indicated no significant cost difference associated with the use of different stent types in PBD procedures.…”

“…Several studies reported that the R0 resection rate improves after neoadjuvant therapy [ 13 , 28 , 29 ]. McClaine et al [ 26 ] reported that performing NAC on BR pancreatic cancer increased the R0 resection rate to 67%, and Kubota et al [ 27 ] reported that neoadjuvant chemoradiation therapy for the treatment of BR pancreatic cancer increased the R0 resection rate to 97% (33/34). However, there have been no studies on the effect that different stent types used in PBD have on the R0 resection rate.…”

Increased morbidity and mortality of a concomitant colectomy during a pancreaticoduodenectomy: an NSQIP propensity-score matched analysis

“…A complete surgical resection with a pancreaticoduodenectomy (PD) is a required part of a potentially curative multimodality treatment plan for patients with pancreatic head adenocarcinoma . Despite improvements in neoadjuvant and adjuvant therapies, and surgical techniques, only 15% to 20% of patients are candidates for a resection owing to the presence of a distant tumour outside the confines of a resection, or because of locally advanced disease. Select patients with peri‐ampullary cancers require a multi‐organ resection during a PD to achieve margin‐negative resections.…”

“…1,2 Despite improvements in neoadjuvant and adjuvant therapies, and surgical techniques, only 15% to 20% of patients are candidates for a resection owing to the presence of a distant tumour outside the confines of a resection, or because of locally advanced disease. [2][3][4][5][6] Select patients with peri-ampullary cancers require a multi-organ resection during a PD to achieve marginnegative resections. [7][8][9][10][11][12] A margin-negative, or R0, resection is critical as better oncological outcomes are associated with a successful R0 resection.…”