title: Treatment outcome for systemic chemotherapy for recurrent pancreatic cancer after postoperative adjuvant chemotherapy.
abstract: OBJECTIVE
  A global consensus on how to treat recurrent pancreatic cancer after adjuvant chemotherapy with gemcitabine (ADJ-GEM) does not exist.
  
  
  METHODS
  We retrospectively reviewed the clinical data of 41 patients with recurrences who were subsequently treated with chemotherapy.
  
  
  RESULTS
  The patients were divided into two groups according to the time until recurrence after the completion of ADJ-GEM (ADJ-Rec): patients with an ADJ-Rec < 6 months (n = 25) and those with an ADJ-Rec ≥ 6 months (n = 16). The disease control rate, the progression-free survival after treatment for recurrence and the overall survival after recurrence for these two groups were 68 and 94% (P = 0.066), 5.5 and 8.2 months (P = 0.186), and 13.7 and 19.8 months (P = 0.009), respectively. Furthermore, we divided the patients with an ADJ-Rec < 6 months into two groups: patients treated with gemcitabine (n = 6) and those treated with alternative regimens including fluoropyrimidine-containing regimens (n = 19) for recurrent disease. Patients treated with the alternative regimens had a better outcome than those treated with gemcitabine.
  
  
  CONCLUSIONS
  Fluoropyrimidine-containing regimens may be a reasonable strategy for recurrent disease after ADJ-GEM and an ADJ-Rec < 6 months.
authors.affiliation: Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan.
authors.forename: Tomoko Katsui
authors.initials: TK
authors.lastname: Taniyama
authors.forename: Chigusa
authors.initials: C
authors.lastname: Morizane
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakachi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nara
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kondo
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kosuge
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimada
authors.forename: Minoru
authors.initials: M
authors.lastname: Esaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shuichi
authors.initials: S
authors.lastname: Mitsunaga
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine