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dc.contributor.author김규보-
dc.date.accessioned2020-12-03T16:30:21Z-
dc.date.available2020-12-03T16:30:21Z-
dc.date.issued2020-
dc.identifier.issn0748-7983-
dc.identifier.otherOAK-28202-
dc.identifier.urihttps://dspace.ewha.ac.kr/handle/2015.oak/255588-
dc.description.abstractBackground: This study was conducted to identify patients who may benefit from adjuvant chemoradiotherapy (CRT) for positive or close resection margin (RM) after curative resection of pancreatic adenocarcinoma. Methods: From 2004 to 2015, total of 472 patients with pancreatic adenocarcinoma underwent curative resection. After excluding patients with RM > 2 mm or unknown, remaining 217 patients were retrospectively analyzed. Forty-six (21.2%) patients were treated with adjuvant chemotherapy alone (CTx; mainly gemcitabine-based), 142 (65.4%) with adjuvant CRT (mainly upfront), and 29 (13.4%) patients didn't receive any adjuvant therapy (noTx group). Results: Locoregional recurrence rate was significantly lower in the CRT group (43.7%) than in the CTx group (71.7%) or noTx group (65.5%) (p = 0.001). Significant survival benefits of CRT over CTx (HR 0.602, p = 0.020 for overall survival (OS); HR 0.599, p = 0.016 for time to any recurrence (TTR)) were demonstrated in multivariate analysis. CRT group had more 5-year survivors than other groups. In the subgroup analysis, such benefits of adjuvant CRT over CTx was observed only in patients with head tumor & vascular RM > 0.5 mm, but not in patients with body/tail tumor or vascular RM ≤ 0.5 mm. In the CRT group, radiation dose≥54 Gy was significantly associated with better TTR and OS. Conclusions: Adjuvant CRT could improve TTR and OS compared to adjuvant CTx alone in patients with close RM under 2 mm. Radiation dose escalation may be beneficial when feasible. Modern CRT regimen–based randomized evidence is needed for these high-risk patients. © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology-
dc.languageEnglish-
dc.publisherW.B. Saunders Ltd-
dc.subjectAdjuvant chemoradiotherapy-
dc.subjectPancreatic cancer-
dc.subjectRadiation dose-
dc.subjectResection margin-
dc.titleSurvival benefit of adjuvant chemoradiotherapy for positive or close resection margin after curative resection of pancreatic adenocarcinoma-
dc.typeArticle-
dc.relation.issue11-
dc.relation.volume46-
dc.relation.indexSCIE-
dc.relation.indexSCOPUS-
dc.relation.startpage2122-
dc.relation.lastpage2130-
dc.relation.journaltitleEuropean Journal of Surgical Oncology-
dc.identifier.doi10.1016/j.ejso.2020.07.029-
dc.identifier.wosidWOS:000582238700018-
dc.identifier.scopusid2-s2.0-85089174675-
dc.author.googleKim B.H.-
dc.author.googleKim K.-
dc.author.googleJang J.-Y.-
dc.author.googleKwon W.-
dc.author.googleKim H.-
dc.author.googleLee K.-H.-
dc.author.googleOh D.-Y.-
dc.author.googleLee K.B.-
dc.author.googleChie E.K.-
dc.contributor.scopusid김규보(8213302900)-
dc.date.modifydate20210708164512-
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의과대학 > 의학과 > Journal papers
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