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Adjuvant chemoradiotherapy may improve survival in pancreatic cancer

David Douglas

Last Updated: 2008-08-12 13:11:50 -0400 (Reuters Health)

NEW YORK (Reuters Health) - After resection of pancreatic carcinoma, overall survival appears to be improved in patients who go on to chemotherapy and radiotherapy, according to findings reported in the July 20th issue of the Journal of Clinical Oncology.

Dr. Robert C. Miller of the Mayo Clinic in Rochester, Minnesota and colleagues conducted a retrospective study of 472 patients who underwent complete resection with negative margins for invasive carcinoma of the pancreas at that institution between 1975 and 2005.

Six died within 30 days of surgery. After a median follow-up of 32.4 months, the 466 remaining patients had a median overall survival of 21.6 months. With adjuvant chemotherapy and radiation, median survival was 25.2 months versus 19.2 months with no adjuvant therapy.

Two-year overall survival was 50% with adjuvant chemoradiotherapy and 39% without. For 5-year overall survival, the corresponding rates were 28% and 17%.

Adverse prognostic factors included positive lymph nodes, high histological grade and no adjuvant therapy. However, patients who received adjuvant therapy had significantly more adverse prognostic factors than those who did not.

Commenting on the findings, Dr. Miller told Reuters Health, "As these results are retrospective in nature, they highlight the importance of conducting the planned intergroup trial of adjuvant chemoradiotherapy in resected pancreatic head carcinoma to further test this hypothesis in a prospective manner in the United States."

J Clin Oncol 2008;26:3511-3516.

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