Introduction : Recently, several studies using neoadjuvant treatment have been actively conducted in patients with resectable pancreatic cancer. Neoadjuvant treatment usage in Stage I-II pancreatic cancer increased. These cases are needed to determine its effectiveness, especially clinical T1 stage. So we need to compare the survival benefit of preoperative neoadjuvant treatment in early T stage of pancreatic cancer.

Methods : Two institutional data were included in our analysis (Gangnam severance hospital, Nara medical university hospital). Overall survival and disease-free survival was measured as primary outcomes. 36 patients underwent upfront surgery and 10 patients underwent neoadjuvant treatment between January 2010 and December 2017.

Results : Total patients were 46 patients. However, two patients in the neoadjuvant treatment group did not undergo surgery due to distant metastasis after neoadjuvant treatment. Therefore, 44 patients underwent pancreatectomy in clinical T1 stage of pancreatic cancer. Neoadjuvant regimen consisted of gemcitabine and concomitant radiation of 54 Gray. There was no difference in overall survival between the two groups in patients.( Neoadjuvant group : 5 year overall survival rate = 75%, upfront surgery group : 5 year overall survival rate = 42.7%, p = 0.07). However, the neoadjuvant group tended to have a better survival rate than upfront surgery group. On multivariate analyses, age>65, perineural invasion, R1 resection were identified as independent factors for poor overall survival.

Conclusions : Our results showed more better oncological outcomes in neoadjuvant treatment group. Large scale prospective study will be needed to determine the survival benefits of neoadjuvant treatment for early stage pancreatic cancer.