BACKGROUND: Without prospective data establishing a consensus multimodality approach to borderline resectable @entity788 , institutional treatment regimens vary. This study investigated the outcomes of the clinical pathway at the author's institution, which consists of neoadjuvant @entity136 , @entity1205 , @entity416 , and stereotactic radiotherapy followed by surgery. METHODS: The study reviewed all cases that met the National @entity5 Network (NCCN) diagnostic criteria for borderline resectable @entity788 from 1 January 2006, to 31 December 2013. Pancreatectomy rates, margin status, pathologic response, disease-free survival (DFS), disease-specific survival (DSS), and @entity1349 ( @entity1349 ) were retrospectively examined. Standard statistical methods and Kaplan-Meier survival analysis were used for statistical comparisons. RESULTS: Of 121 @entity1 who met criteria, 101 entered the clinical pathway, and 94 (93.1  %) completed neoadjuvant chemotherapy and radiation therapy. Of the 101 @entity1 , 55 (54.5  %) underwent pancreatectomy, with 53 @entity1 (96.4  %) having microscopically negative margins (R0) and 2 @entity1 (3.6  %) having microscopically positive margins (R1). Vascular resection was required for 22 @entity1 (40  %), with rates of 95.5  % for R0 (n  =  21) and 4.5  % for R1 (n  =  1). A pathologic response to treatment was demonstrated by 45 @entity1 (81.8  %) and a complete response by 10 @entity1 (14.5  %). Pancreatectomy resulted in a median DFS of 23  months (95  % conflidence interval [CI] 14.5-31.5), a median DSS of 43  months (95  % CI, 25.7-60.3), and a median @entity1349 of 33  months (95  % CI, 25.0-41.0) versus a median DSS and @entity1349 of 14  months (95  % CI, 10.9-17.1) for @entity1 without pancreatectomy (DSS: P  =  3.5  *  10(-13); @entity1349 : P  =  4.7  *  10(-10)). CONCLUSIONS: The study demonstrated high rates for neoajduvant therapy completion (93.1  %) and pancreatectomy (54.5  %). After pancreatectomy, DSS was significantly improved (43  months), with a pathologic response demonstrated by 81.8  % and a complete response by 14.5  % of the @entity1 . The results support further study of this borderline resectable @entity788 clinical pathway.

Outcomes of a Clinical Pathway for Borderline Resectable XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic adenocarcinoma'] @entity416 :: ('MESH:C110904', 'Chemical') :: ['capecitabine'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Comprehensive Cancer'] @entity136 :: ('MESH:C056507', 'Chemical') :: ['gemcitabine'] @entity1205 :: ('MESH:C067311', 'Chemical') :: ['docetaxel'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity788 :: (MESH:D010190,Disease) :: ['Pancreatic Cancer']
