Preoperative Chemotherapy Does Not Adversely Affect Pancreatic Structure and Short-Term Outcome after Pancreatectomy

Background: Preoperative chemotherapy (PCHT) has recently been proposed also in patients with resectable pancreatic adenocarcinoma. Few data are currently available on the impact of PCHT on short-term postoperative outcome after pancreatic resection. The objective of this study is to assess the impact of PCHT on pancreatic structure and short-term outcome after surgical resection. Methods: Fifty consecutive patients successfully underwent resection after PCHT. Each patient was matched with two control patients with pancreatic adenocarcinoma selected from our prospective electronic database. Match criteria were age (±3 years), gender, American Society of Anesthesiologist score, type of resection, pancreatic duct diameter (±1 mm), and tumor size (±5 mm). Primary endpoint was morbidity rate. Secondary endpoints were pancreatic parenchymal structure, mortality rate, and length of hospital stay (LOS). Results: Both degree of fibrosis and fatty infiltration of the pancreas were similar in the two groups. Overall morbidity rate was 48. 0 % in the PCHT group vs. 54. 0 % in the control group (p = 0. 37). Pancreatic fistula rate was 18. 0 % in the PCHT group vs. 25. 0 % in the control group (p = 0. 41). Mortality was 4. 0 % in the PCHT group vs. 2. 0 % in the control group (p = 0. 60). Mean LOS (days) was 12. 7 in the PCHT group vs. 12. 4 in the control group (p = 0. 74). There was no difference in resection margin status, while the rate of patients without nodal involvement was higher in the PCHT group (46. 0 vs. 23. 0 %, p = 0. 004). Conclusion: PCHT did not induce significant structural changes in pancreatic parenchyma and did not adversely affect short-term outcome after surgery.