title: Novel postoperative adjuvant strategy prevents early hepatic recurrence after resection of pancreatic cancer.
abstract: OBJECTIVE
  It has been reported recently that adjuvant gemcitabine prolonged postoperative disease-free survival in patients with resectable pancreatic cancer. However, the efficacy was limited and further studies are required to improve the prognosis. In particular, postoperative hepatic recurrence often occurs even after gemcitabine treatment.
  
  
  METHODS
  We are currently trying to evaluate the efficacy of postoperative combination therapy of high-dose 5-fluorouracil (5-FU) arterial infusion with systemic gemcitabine. Patients received weekly high-dose 5-FU through the hepatic artery using a port-catheter system (1000 mg/m(2) for 5 h) plus concurrent systemic gemcitabine (1000 mg/m(2)).
  
  
  RESULTS
  Thirty-one patients were enrolled and 29 patients (94%) completed the scheduled adjuvant chemotherapy. The toxicity was acceptable and this regimen was well feasible as an outpatient treatment. At the time of analysis, 21 patients (68%) had recurrence. Local recurrence was most frequently observed, in 43% of the patients with recurrence. On the other hand, hepatic recurrence developed in only 2 patients (10%). The 1-year disease-free rate and overall survival rate were 62.9 and 100%, respectively.
  
  
  CONCLUSIONS
  Our novel adjuvant strategy had a significant beneficial effect on early hepatic recurrence and may have the potential to prolong the overall survival of pancreatic cancer patients.
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. m-sho@naramed-u.ac.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamada
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Akahori
authors.forename: Jin
authors.initials: J
authors.lastname: Doh
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yamato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hokuto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishiofuku
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Marugami
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kanehiro
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents