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Adjuvant Chemoradiation Therapy for Adenocarcinoma of the Distal Pancreas

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study was designed to examine the effect of adjuvant 5-FU-based chemoradiation therapy (CRT) after distal pancreatectomy for adenocarcinoma of the distal pancreas.

Methods

All patients underwent curative resection for adenocarcinoma of the distal pancreas between December 1985 and June 2006. Patients who received adjuvant CRT were compared with those who underwent surgery alone. A Kaplan–Meier estimate of the survival curve was used to determine estimates of the median survival and proportion alive at 1 and 2 years; log-rank tests were used to make comparisons between groups.

Results

A total of 123 patients underwent distal pancreatectomy; 29 patients were excluded for distant metastases at the time of surgery (n = 12, 10%) or before adjuvant therapy (n = 11, 9%), death within 2 months of surgery (n = 2, 2%), or if CRT treatment status was unknown (n = 4, 3%). Of the remaining 94 patients, 72% received adjuvant 5-FU-based CRT and 28% underwent surgery alone. Overall median survival was 16.2 (95% confidence interval (CI), 13.1–18.9) months. The groups were similar with respect to tumor size, nodal status, and margin status. There was no significant difference in overall survival between patients treated with adjuvant CRT versus surgery alone (p = 0.23). An exploratory subgroup analysis suggested a potential survival benefit of adjuvant CRT in patients with lymph node metastases (16.7 vs. 12.1 months, p < 0.01).

Conclusions

Adjuvant CRT did not increase survival compared with surgery alone; however, patients with node-positive disease appear to benefit from adjuvant CRT.

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Authors and Affiliations

  1. Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kristin J. Redmond MD, MPH, Julia Ahn BA & Joseph M. Herman MD, MSc

  2. Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christopher L. Wolfgang MD, PhD, Hari Nathan MD, Daniel Laheru MD, Barish H. Edil MD, Michael A. Choti MD, Timothy M. Pawlik MD & John L. Cameron MD

  3. Department of Epidemiology, The Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA

    Elizabeth A. Sugar PhD

  4. Department of Biostatistics, The Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA

    Elizabeth A. Sugar PhD

  5. Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ralph H. Hruban MD

Authors
  1. Kristin J. Redmond MD, MPH
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  2. Christopher L. Wolfgang MD, PhD
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  3. Elizabeth A. Sugar PhD
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  4. Julia Ahn BA
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  5. Hari Nathan MD
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  6. Daniel Laheru MD
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  7. Barish H. Edil MD
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  8. Michael A. Choti MD
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  9. Timothy M. Pawlik MD
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  10. Ralph H. Hruban MD
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  11. John L. Cameron MD
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  12. Joseph M. Herman MD, MSc
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Corresponding author

Correspondence to Joseph M. Herman MD, MSc.

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Redmond, K.J., Wolfgang, C.L., Sugar, E.A. et al. Adjuvant Chemoradiation Therapy for Adenocarcinoma of the Distal Pancreas. Ann Surg Oncol 17, 3112–3119 (2010). https://doi.org/10.1245/s10434-010-1200-3

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  • DOI: https://doi.org/10.1245/s10434-010-1200-3

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