- (2011) Volume 12, Issue 1
Amanjeet Singh, Tanveer Singh, Adarsh Chaudhary
Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, Rajinder Nagar. New Delhi, India
Received November 27th, 2010
Chemotherapy, Adjuvant; Neoplasm Metastasis; Pancreatic Neoplasms
Dear Sir,
We thank Dr. Saif for showing interest in our article [1]. Our aim was only to present our limited experience with synchronous resections in a selected group of patients. We agree with Dr. Saif that this should be performed in a high volume center and only a small number of patients are candidates for these procedures. We used gemcitabine-based adjuvant therapy in patients who received this procedure: all the patients in the synchronous selected group and 134 (60.1%) of the other 223 patients.
In this study, three patients with pancreatic head cancer underwent synchronous resection of a liver metastasis along with the primary tumors. On follow-up, two developed local recurrences and only one had systemic disease in the form of liver metastases. This indicates the probable locally aggressive nature of the disease rather than a distant metastasis.
There is some evidence available for the use of neoadjuvant treatment for locally unresectable tumors detected on preoperative imaging [2], but its role in resectable pancreatic cancers [3] and in patients with metastatic disease in an otherwise resectable cancer needs to be investigated in future studies.
The authors have no potential conflict of interest
