Borderline resectable pancreatic cancer (BRPC) is frequently associated with positive surgical margins and a poor prognosis because the tumor is in contact with major vessels. This study evaluated the relationship between the margin-negative (R0) resection rate and findings indicating peripancreatic vascular invasion on multidetector computed tomography (MDCT) imaging after neoadjuvant chemoradiotherapy (NACRT) in patients with BRPC. Twenty-nine BRPC patients who underwent laparotomy after neoadjuvant S-1 with concurrent radiotherapy were studied retrospectively. Peripancreatic major vessel invasion was evaluated based on the length of tumor-vessel contact on MDCT. The R0 resection rates were compared between the progression of vascular invasion (PVI) group and the non-progression of vascular invasion (NVI) group. There were 3 patients with partial responses (10%), 25 with stable disease (86%), and 1 with progressive disease (3%) according to the RECISTv1.1 criteria. Regarding vascular invasion, 9 patients (31%) were classified as having PVI, and 20 patients (69%) were classified as having NVI. Of the 29 patients, 27 (93%) received an R0 resection, and all the PVI patients received an R0 resection (9/9; R0 resection rate = 100%) while 90% (18/20) of the NVI patients underwent an R0 resection. The exact 95% confidence interval of risk difference between those R0 resection rates was − 10.0% [− 31.7–20.4%]. Patients with BRPC after NACRT achieved high R0 resection rates regardless of the vascular invasion status. BRPC patients can undergo R0 resections unless progressive disease is observed after NACRT. UMIN-CTR, UMIN000009172 . Registered 23 October 2012

中文翻译：

---

边缘性可切除胰腺癌患者新辅助 S-1 和同步放疗后手术 R0 可切除性与 CT 成像胰周血管侵犯表现之间的关系


交界性可切除胰腺癌 (BRPC) 通常与手术切缘阳性和预后不良相关，因为肿瘤与主要血管接触。本研究评估了 BRPC 患者新辅助放化疗 (NACRT) 后切缘阴性 (R0) 切除率与多排计算机断层扫描 (MDCT) 成像显示胰周血管侵犯的结果之间的关系。对 29 例在新辅助 S-1 联合放疗后接受剖腹手术的 BRPC 患者进行回顾性研究。根据MDCT上肿瘤-血管接触的长度来评估胰周主要血管的侵犯。比较血管侵犯进展（PVI）组与血管侵犯未进展（NVI）组的R0切除率。根据 RECISTv1.1 标准，有 3 名患者部分缓解（10%），25 名患者疾病稳定（86%），1 名患者疾病进展（3%）。关于血管侵犯，9 名患者（31%）被归类为患有 PVI，20 名患者（69%）被归类为患有 NVI。在 29 例患者中，27 例（93%）接受了 R0 切除，所有 PVI 患者均接受了 R0 切除（9/9；R0 切除率 = 100%），而 90%（18/20）的 NVI 患者接受了 R0 切除。 R0切除。 R0 切除率之间风险差异的确切 95% 置信区间为 − 10.0% [− 31.7–20.4%]。无论血管侵犯状态如何，NACRT 后 BRPC 患者均获得较高的 R0 切除率。 BRPC 患者可以接受 R0 切除，除非 NACRT 后观察到疾病进展。 UMIN-CTR，UMIN000009172。注册日期：2012 年 10 月 23 日