Outcome of Patients with Borderline Resectable Pancreatic Cancer in the Contemporary Era of Neoadjuvant Chemotherapy

Image credit: Zaky, AM, Wolfgang, CL, Weiss, MJ, et al. (2016). Tumor-vessel relationships in pancreatic ductal adenocarcinoma at multidetector CT: different classification systems and their influence on treatment planning. RadioGraphics; 37(1):93-112

The following study was recently published in the Journal of Gastrointestinal Surgery by Ammar A. Javed and colleagues in September 2018. Below is a summary of the article.

Localized pancreatic cancer can be classified into resectable, borderline resectable and locally advanced lesions based on the degree of involvement of adjacent blood vessels (portal vein, superior mesenteric artery and celiac artery). Borderline resectable tumors are those that have limited invasion of the vessels and, while surgically resectable, carry a high risk of positive margins at the time of resection (see prior Nikki Mitchell Foundation article on margin status). Chemotherapy available for pancreatic cancer has improved significantly over the last decade. With effective therapies now available, a majority of patients with borderline resectable disease now receive preoperative chemotherapy. The authors sought to evaluate the outcomes of patients undergoing surgery for borderline resectable pancreatic cancer at a single high-volume center.

The authors identified 151 patients from their multidisciplinary clinic who were diagnosed with borderline resectable pancreatic cancer. 142 (94.0%) patients received chemotherapy and 78 (51.7%) received radiation therapy. Ninety-six (63.6%) were able to undergo surgery, while 12 (7.9%) patients were taken to the operating room but their procedure was aborted due to extensive disease. 47 (31.1%) of patients unfortunately had progression of disease and were deemed to be unresectable at follow up. Patients who underwent surgery had a median overall survival of 28.8 months as compared to 13.5 months in those who did not receive surgery.

Take home points:

  • Multidisciplinary management is vital for borderline resectable pancreatic cancer.
  • Resection of borderline resectable pancreatic cancer is safe when performed by experienced surgeons at a high volume institution.
  • The rate of resection in patients with borderline pancreatic cancer is approximately 65%.
  • Surgical resection of borderline resectable pancreatic cancer is associated with improved overall survival.
  • Disease progression while receiving chemotherapy is the most frequent reason for unresectability.

You can read the entire article here.

A special thanks for this summary by Michael Wright, Department of Surgery, Johns Hopkins School of Medicine and Dr. Ammar Javed for his support.

The 7th Annual Jamey Johnson Golf Tournament Raises $421,500 to Fight Pancreatic Cancer

Participants included Dennis Quaid, Ron White, Randy Houser, Kellie Pickler, Jerrod Niemann and pro golfers John Daly and Boo Weekley

The 7th Annual Jamey Johnson Golf Tournament raised $421,500 for the Nikki Mitchell Foundation to help fight pancreatic cancer.

In addition, the Sept. 30 event, which was held at the Cottonwood Golf Club in Johnson’s hometown of Montgomery, Ala., raised about $5,000 in money and toys for the Montgomery area Marine Toys for Tots.

Celebrity golfers included professional golfers John Daly and Boo Weekley, as well as actor Dennis Quaid, comedian Ron White and musical artists/songwriters Randy Houser, Jerrod Niemann, Kellie Pickler, Ray Scott, Keith Gattis and Rob Hatch.

The tournament featured a live auction and multi-artist concert, which was unfortunately cut short this year by the rain.

“I couldn’t be more proud of the Nikki Mitchell Foundation for putting on a wonderful tournament again this year,” says Jamey Johnson. “The seventh in a row was really something. I am very proud of our sponsors, as well as everybody who made donations and bought auction items.”

“I am especially proud and grateful of my hometown for showing up at the concert in droves the way they did in the rain,” he says. “It was heartwarming and very impressive. I love Montgomery and I love Alabama.”

“We will definitely be back to do number eight in 2019,” he says. “A lot of our special guests this year have vowed to return if at all possible and do the concert again next yea, including Dennis, Quaid, Ron White, Drivin’ N Cryin’, and other guests. The thing I love the most about the tournament is you never know who is going to be there. It is good to know who you can count on. “

Event sponsors included Hampton Inn Eastchase, Nitro Oil and Capitol Container.

“The money will be used for our direct patient services program, which provides monthly financial aid to pancreatic cancer patients, and for Pancreatic Cancer Research Awards,” says Rhonda Miles, president of the Nikki Mitchell Foundation.

One of the tournament’s highlights included the hole-in-one by Richard Tate of Butler, KY, who won a Ford Eco Sport donated by Collier Ford in Wetumpka, Ala. The event featured teams representing eight states, with 40 percent of the teams coming from the Montgomery area.

“I am very proud of everybody pulling together and making this happen they way they did. Nikki would be proud too,” Johnson says.