{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T10:29:35Z","timestamp":1764152975983,"version":"3.46.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unresectable pancreatic cancer (UR\u2010PC) has a poor prognosis. Although conversion surgery has been considered a promising strategy for improving prognosis in UR\u2010PC, the clinical benefit offered to patients with UR\u2010PC remains controversial. This study aimed to investigate the clinical benefits of conversion surgery in patients with UR\u2010PC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated patients with UR\u2010PC referred to our department for possible surgical resection between January 2008 and June 2017. Resectability was evaluated using multimodal imaging in patients who underwent chemotherapy for more than 6\u00a0months. Conversion surgery was performed only in patients who were judged eligible for R0 resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 90 patients were evaluated. Among them, only 22 (24.4%) could actually undergo conversion surgery, and the R0 resection rate was 72.7% (16\/22). Although Evans grade\u2009\u2265\u2009IIB was noted in six patients (27.3%), none achieved complete response (CR). The median survival time was significantly longer among patients who underwent conversion surgery than in the unresected patients who underwent chemotherapy (21.3\u00a0months vs. 12.6\u00a0months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate and Kaplan\u2013Meier analyses revealed microvascular invasion to have a significant adverse effect on recurrence\u2010free survival (RFS: 7\u00a0months vs. not reached,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and overall survival (OS: 21\u00a0months vs. 85\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After long\u2010term chemotherapy, conversion surgery for UR\u2010PC is associated with long\u2010term survival. Microvascular invasion is predictive of poor prognosis in these patients; adjuvant protocols are therefore needed for patients with microvascular invasion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05503-4","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T12:02:42Z","timestamp":1586865762000},"page":"2752-2760","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Role of Conversion Surgery for Unresectable Pancreatic Cancer After Long\u2010Term Chemotherapy"],"prefix":"10.1002","volume":"44","author":[{"given":"Nobuhiro","family":"Tsuchiya","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery, Graduate School of Medicine Yokohama City University 3\u20109 Fukuura, Kanazawa\u2010ku 236\u20100004 Yokohama 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