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[Members Only] J.Jpn. Surg. Soc.. 120(4): 413-417, 2019
Feature topic
CONVERSION SURGERY AFTER A FAVORABLE RESPONSE TO MULTIMODALITY TREATMENT IN PATIENTS WITH UNRESECTABLE LOCALLY ADVANCED PANCREATIC DUCTAL ADENOCARCINOMA
Pancreatic ductal adenocarcinoma (PDAC) continues to be a lethal disease, because most (70-80％) patients are classified as having unresectable (UR) disease. Recent progress in multimodality treatment has led to higher response rates and improved short-term survival. Recently, conversion surgery (CS), which is defined as an additional surgery during multimodality treatment in patients with initially UR-PDAC who respond favorably to anticancer treatments, has been introduced for locally advanced (UR-LA) PDAC. Several studies demonstrated acceptable mortality and morbidity rates. CS resulted in longer median survival times relative to patients who did not undergo CS. However, the actual clinical benefits of resection have not yet been fully investigated, and there are still several issues to be resolved in this area. Therefore, sustained efforts to conduct appropriately designed clinical trials for confirming the efficacy of CS in the subset of patients with initially UR-LA PDAC are warranted.
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