Upfront Surgery and Surgery Following Neoadjuvant Treatment of Pancreatic Ductal Adenocarcinoma: A Comparative Analysis of Short-term Postoperative Outcomes

Abstract

Background/aim: In cases where neoadjuvant treatment (NAT) is administered, research on short-term postoperative outcomes appears to be insufficient. We compared short-term outcomes of upfront surgery (UpS) cases and NAT cases for pancreatic ductal adenocarcinoma (PDAC).

Patients and methods: We retrospectively reviewed 1,228 cases that had elective pancreatectomy at Samsung Medical Center from 2010 to 2020. All cases were classified into resectable pancreatic cancer (RPC) and locally advanced pancreatic cancer (LAPC) according to NCCN guidelines 2017. In each group, factors were compared between the UpS and NAT groups.

Results: Rate of vascular resection was higher in the NAT group in RPC, compared to that in the NAT group in LAPC. Short-term postoperative outcomes had no significant differences between the UpS and NAT groups in both RPC and LAPC.

Conclusion: In the NAT group, there were no significant differences from UpS in terms of short-term postoperative outcomes. Conversion surgery following NAT is a favorable strategy.

Keywords: Resectable pancreatic cancer; locally advanced pancreatic cancer; neoadjuvant treatment; short-term postoperative outcomes; upfront surgery.