The clinical efficacy of adjuvant systemic chemotherapy with gemcitabine in node-positive pancreatic cancer

Hepatogastroenterology. May-Jun 2004;51(57):634-7.

Abstract

Background/aims: The effects of gemcitabine in postoperative adjuvant chemotherapy were evaluated in patients suffering from locally advanced pancreatic cancer with lymph node metastases. The results were compared with those of our historical control patients treated by surgery alone.

Methodology: Twenty-one patients with node-positive pancreatic cancer who had undergone a pancreatic resection with curative intent over the five years up to February 2003, were enrolled in this study. Nine cases received postoperative adjuvant chemotherapy with biweekly administration of 1000 mg/m2 gemcitabine, while the remaining 12 cases underwent surgery without any adjuvant chemotherapy.

Results: The chemotherapy was well tolerated with only mild symptomatic and hematologic toxicities. The overall cumulative survival rates of the chemotherapy and surgery-alone groups were 86% and 75% at one year, and 50% and 0% at two years, with a median survival of 20.3 months and 15.4 months, respectively (p=0.0084). The disease-free interval was also significantly greater in the chemotherapy group compared with the surgery-alone group (p=0.0244).

Conclusions: Adjuvant systemic chemotherapy utilizing gemcitabine was feasible with acceptable adverse effects and improved the survival rate of patients with node-positive pancreatic cancer. Although further investigation is needed to confirm these results, gemcitabine is a promising agent for the treatment of resectable advanced pancreatic cancer.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Chemotherapy, Adjuvant
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Postoperative Complications / etiology
  • Survival Rate

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • gemcitabine