In spite of controversial issues,
pancreatectomy following
neoadjuvant chemoradiation therapy (NeoCRT) has been applied in treating advanced
pancreatic cancer. Cases of pathological complete remission (pCR) following NeoCRT is rare, and its long-term follow-up data are still lacking.From January 2000 to December 2012, medical records of the patients who underwent
pancreatectomy for pancreatic ductal
adenocarcinoma were retrospectively reviewed. Characteristics of the patients with pCR were summarized and their long-term follow-up data were analyzed.Among 86 patients with
pancreatic cancer who underwent radical
pancreatectomy following NeoCRT, 10 patients (11.6%) were reported to pCR. Nine out of 10 patients received
gemcitabine-based chemoradiation
therapy. Median pre-NeoCRT serum CA 19-9 was 313.5 U/ml, and post-NeoCRT serum CA 19-9 was 9.9 U/ml, which was shown to be significant difference between 2 serum CA 19-9 level (P = 0.005). Pylorus-preserving
pancreaticoduodenectomy was done in 8 patients, and the others received distal pancreatosplenectomy. Postoperative
chemotherapy was received in 6 patients. Disease-free survival was statistically superior in patients with pCR than patients without pCR (P < 0.05). However, 5 patients experienced
cancer recurrence and no clinicopathologic variables including preoperative resectability could not predict the potential recurrence of
tumor in patients with pCR (P > 0.05).pCR is rarely reported following NeoCRT, but this condition is not telling the cure of the disease. Early recurrence in the pattern of liver
metastasis and peritoneal seeding can be expected. However, long-term survival could be maintained in patients without recurrence. Further investigation is necessary for predicting failure of treatment.