Ijin Joo MD, Presenter: Nothing to Disclose

Jeong Min Lee MD, Abstract Co-Author: Research Grant, Guerbet SA Equipment support, Siemens AG Research Grant, Bayer AG

Dong Ho Lee MD, Abstract Co-Author: Nothing to Disclose

Eun Sun Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Joon Koo Han MD, Abstract Co-Author: Nothing to Disclose

Byung Ihn Choi MD, PhD, Abstract Co-Author: Research Consultant, Samsung Electronics Co Ltd

To prospectively evaluate the effects of neoadjuvant concurrent chemoradiation therapy (CCRT) in the preoperative assessment of resectability using MDCT in patients with borderline resectable pancreas cancer

In this on-going prospective study, a total of 27 patients with borderline resectable pancreas cancer were enrolled and divided into two randomized groups: 15 patients to upfront surgery (group 1) and 12 patients to neoadjuvant CCRT followed by surgery (group 2). Contrast-enhanced MDCT images obtained immediately prior to surgery were retrospectively reviewed by two independent radiologists to determine the resectability of pancreas cancers. The diagnostic accuracies of MDCT in prediction of resectability between group 1 and group 2 were compared using the Fisher exact test.

Among 27 patients with borderline resectable pancreas cancers, 10 patients were confirmed as having resectable disease (R0 resection) and 17 patients were confirmed as having unresectable disease (R1 or R2 resection in 15 patients; inoperable due to distant metastases were found before surgery in 2 patients). The overall accuracies of the two reviewers in determining resectability of borderline resectable pancreas cancers were higher in patients who underwent upfront surgery (86.7% and 86.7% in reviewer 1 and 2, respectively) than in patients who had received neoadjuvant CCRT (66.7% and 66.7% in reviewer 1 and 2, respectively), however, the differences were not statistically significant (P>0.05).

Our preliminary data from a prospective randomized study show that neoadjuvant CCRT may reduce the accuracy of MDCT in prediction of resectability in patients with borderline resectable pancreas cancers. 

In borderline resectable pancreas cancers, neoadjuvant concurrent chemoradiation therapy may reduce the diagnostic accuracy of MDCT in prediction of resectability. 

Joo, I, Lee, J, Lee, D, Lee, E, Han, J, Choi, B, Effects of Neoadjuvant Concurrent Chemoradiation Therapy in the Performance of MDCT in Determining Resectability of Borderline Resectable Pancreas Cancer: Preliminary Results of a Prospective Randomized Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003985.html