title: Long-term effects of multimodal treatment for patients with resectable carcinoma of the pancreas.
abstract: The treatment of pancreatic carcinoma remains one of the most formidable challenges in oncology. Curative resection, currently the only available treatment option, provides no significant impact on long-term survival. The recent development of multimodal treatment options for pancreatic cancer has provided clinical benefits and improved patient survival. In this study, we retrospectively evaluated our experiences with multimodal therapy, including radiotherapy and chemotherapy with gemcitabine, for the treatment of resectable pancreatic cancer. Fifty-eight patients with ordinary pancreatic carcinoma who underwent surgical resection at Kochi Medical School were studied. The clinical and pathological factors and multimodal treatment for pancreatic carcinoma that influenced patient survival were analyzed. Cumulative 1-, 3- and 5-year survival rates after surgery for ordinary pancreatic carcinoma were 62.2, 20.3 and 20.3%, respectively. The overall 4-year survival rate of patients subjected to adjuvant chemotherapy with gemcitabine after curative resection for ordinary pancreatic carcinoma is 39.1%. Adjuvant chemotherapy with gemcitabine provided a significantly better prognosis for patients following curative surgical resection than curative surgical resection alone (P=0.035). Although the rate of survival was greater for patients who underwent radiotherapy than those who did not, the difference was not statistically significant (P=0.054). Postoperative local recurrence around the nerve plexus of celiac and superior mesenteric arteries was better controlled in patients who underwent radiotherapy than those who did not. Adjuvant chemotherapy with gemcitabine after curative resection provides a significant survival benefit for patients with pancreatic carcinoma. Our results suggest that the postoperative recurrence of ordinary pancreatic carcinoma will be reduced by multimodal treatment using radiotherapy and adjuvant chemotherapy with gemcitabine.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan. tokabaya@kochi-u.ac.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Isao
authors.initials: I
authors.lastname: Nishimori
authors.forename: Akihito
authors.initials: A
authors.lastname: Nishioka
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Takeki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Ken
authors.initials: K
authors.lastname: Dabanaka
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Kohsaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Saburo
authors.initials: S
authors.lastname: Onishi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000592:standards / Q000639:trends*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012264:Ribonucleotide Reductases / Q000037:antagonists & inhibitors; D015996:Survival Rate; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D012264:Ribonucleotide Reductases; D000093542:Gemcitabine