Morphological background of intraoperative radiation therapy appliance to prevent locoregional progression in patients with pancreatic ductal adenocarcinoma
https://doi.org/10.18027/2224-5057-2017-1-52-60
Abstract
Background. It is well recognized that pancreatic ductal adenocarcinoma (PDAC) is associated with very poor prognosis, early locoregional invasion and distant metastases. One reason for this is the proliferation of tumor growth through perineural spaces.
Aim. To evaluate the efficacy of intraoperative radiation therapy (IORT) for the extrapancreatic perineural invasion (EPPI) in the development of locoregional recurrence in patients with PDAC.
Results. In 14.5% (22/152) the tumor was pT1–2, pN0, extraPn 0, R0. R1 detected in 32.1% (49/152). ExtraPn was detected in 36.8% of cases (56/152). Metastases in regional lymph nodes was found in 62.5% (95/152) of cases. In the study of autopsy
basic morphological parameters speakers include locoregional tumor progression and / or a distant progression. Locoregional recurrence was found in 85% of cases (29/34), which is manifested by the presence of perineural invasion. The mean time from surgery until locoregional recurrence without extraPn –14 months, with the presence of extraPn – 9 months.
Conclusion. Thus, the absence of regional lymph nodes and/or with positive surgical margin does not preclude the development of locoregional recurrence in patients with PDAC. This is what necessitates a combined approach to the treatment of these patients, including surgery, supplemented by conducting IORT that effectively influences on tissues and reduces the number of local recurrence.
About the Authors
G. R. SETDIKOVA
Botkin Municipal hospital
Russian Federation
MD, PhD, pathologist
Russian Federation
MD, PhD, pathologist
A. A. KARPOV
Botkin Municipal hospital
Russian Federation
surgeon, HPB department
Russian Federation
surgeon, HPB department
O. V. PAKLINA
Botkin Municipal hospital
Russian Federation
MD, PhD, DSc, professor, head of the Department of Pathology
Russian Federation
MD, PhD, DSc, professor, head of the Department of Pathology
G. V. KNISHINSKY
Botkin Municipal hospital
Russian Federation
pathologist
Russian Federation
pathologist
M. M. TAVOBILOV
Botkin Municipal hospital
Russian Federation
MD, PhD, head of the department RMAPS
Russian Federation
MD, PhD, head of the department RMAPS
A. V. SHABUNIN
Botkin Municipal hospital
Russian Federation
MD, PhD, DSc, chief professor of surgery department RMAPS
Russian Federation
MD, PhD, DSc, chief professor of surgery department RMAPS
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For citations:
SETDIKOVA G.R., KARPOV A.A., PAKLINA O.V., KNISHINSKY G.V., TAVOBILOV M.M., SHABUNIN A.V. Morphological background of intraoperative radiation therapy appliance to prevent locoregional progression in patients with pancreatic ductal adenocarcinoma. Malignant tumours. 2017;(1):52-60. (In Russ.) https://doi.org/10.18027/2224-5057-2017-1-52-60
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