Long-term Survival and Metastatic Pattern of Pancreatic and Periampullary Cancer After Adjuvant Chemoradiation or Observation

• DOI: 10.1097/sla.0b013e318156eef3
• Publication Date: 2009-03-03T23:41:05Z
• Authors: Hans G. Smeenk; Casper H. J. van ...; Wim C. Hop; Joris Erdmann; Kheetje C. K. Tran; Muriel Debois; Eric van Cutsem; Herman van Dekken; Jean H. Klinkenbijl; Johannes Jeekel
• Keywords: Periampullary cancer; Chemoradiotherapy

In Brief Background: The role of adjuvant chemoradiation in pancreatic cancer remains unclear. This report presents the long-term follow-up results EORTC trial 40891, which assessed resectable cancer. Methods: Two hundred eighteen patients were randomized after resection primary tumor. Eligible had T1–2 N0-N1a M0 or T1–3 periampullary cancers, all histologic proven. Patients treatment group (n = 110) underwent postoperative (40 Gy plus 5-FU). control 108) no further treatment. Findings: After a median 11.7 years, 173 deaths (79%) have been reported. overall survival did not differ between 2 groups (Chemoradiation vs. Controls: death rate ratio 0.91, 95% CI: 0.68–1.23, P value 0.54). 10-year was 18% whole population (8% head and 29% group). Interpretation: These confirm previous short-term analysis, indicating benefit over observation with resected may survive more than 10 years. Only 1 31 cases recurred year 7.