Adjuvant therapies in extended pancreatectomy for ductal adenocarcinoma of the pancreas.
OBJECTIVE
The poor prognosis after pancreatic cancer resection is attributed to a high incidence of locoregional recurrence and hepatic metastasis. The present study was carried out in order to determine whether adjuvant therapies improve patient survival.


METHODS
Preoperative irradiation and postoperative liver perfusion chemotherapy have been added to the extended pancreatectomy procedure, and a retrospective analysis of 111 patients was performed.


RESULTS
Preoperative irradiation (n = 17) significantly decreased the incidence of locoregional recurrence but increased the incidence of hepatic metastasis, with no improvement in the 5-year survival rate (from 27% to 23%). In contrast, postoperative liver perfusion chemotherapy (n = 27) succeeded in improving the 5-year survival rate to 39% by significantly decreasing the incidence of hepatic metastasis.


CONCLUSIONS
These data suggest that the patients' survival rate may be increased when these two types of adjuvant therapy are combined with extended pancreatectomy.
Ishikawa
O
O
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Ohigashi
H
H
Sasaki
Y
Y
Masao
K
K
Kabuto
T
T
Furukawa
H
H
Imaoka
S
S
D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000517:prevention & control / Q000556:secondary; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome