Original ArticlesDoes pre‐operative chemoradiation for initially unresectable or borderline resectable pancreatic adenocarcinoma increase post‐operative morbidity? A case‐matched analysis

BackgroundNeoadjuvant chemoradiation therapy for locally unresectable and borderline resectable pancreatic cancer may allow some patients to a undergo a resection, but whether or not this increases post‐operative morbidity remains unclear.MethodsThe post‐operative morbidity of 29 patients with initially locally unresectable/borderline pancreatic cancer who underwent a resection were compared with 29 patients with initially resectable tumours matched for age, gender, the presence of comorbidities (yes/no), American Society of Anesthesiology (ASA) score, tumour location (head/body‐tail), procedure (pancreaticoduodenectomy/distal pancreatectomy) and vascular resection (yes /no). Wilcoxon's signed ranks test was used for continuous variables and McNemar's chi‐square test for categorical variables.ResultsCompared with patients with initially resectable tumours, patients who underwent a resection after pre‐operative chemoradiation therapy had similar rates of overall post‐operative complications (55% versus 41%, P = 0.42), major complications (21% versus 21%, P = 1), pancreatic leaks and fistulae (7% versus 10%, P = 1) and mortality (0% versus 1.7%, P = 1).ConclusionAlthough some previous studies have suggested differences in post‐operative morbidity after chemoradiation, our case‐matched analysis did not find statistical differences in surgical morbidity and mortality associated with pre‐operative chemoradiation therapy.