Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2007; 13(21): 2945-2951
Published online Jun 7, 2007. doi: 10.3748/wjg.v13.i21.2945
Impact of preoperative chemoradiotherapy on survival in patients with resectable pancreatic cancer
Pälvi Vento, Harri Mustonen, Timo Joensuu, Päivi Kärkkäinen, Eero Kivilaakso, Tuula Kiviluoto
Pälvi Vento, Harri Mustonen, Eero Kivilaakso, Tuula Kiviluoto, Departments of Surgery, Helsinki University Central Hospital, Helsinki, Finland
Timo Joensuu, Departments of Oncology, Helsinki University Central Hospital, Helsinki, Finland
Päivi Kärkkäinen, Departments of Pathology, Helsinki University Central Hospital, Helsinki, Finland
Author contributions: All authors contributed equally to the work.
Correspondence to: Pälvi Vento MD, Kotkantie 41, Department of Surgery, Kymenlaakso Central Hospital, Finland. palvi.vento@pp.inet.fi
Telephone: +358-44-223 1419 Fax: +358-5-2205891
Received: March 6, 2007
Revised: March 20, 2007
Accepted: March 26, 2007
Published online: June 7, 2007
Abstract

AIM: To explore whether preoperative chemoradiation therapy improves survival of patients with pancreatic cancer undergoing resectional surgery.

METHODS: Forty-seven patients with a malignant pancreatic tumor localized in the head or uncinate process of the pancreas underwent radical pancreatico-duodenectomy. Twenty-two received chemoradiation therapy (gemcitabine and radiation dose 50.4 Gy) before surgery (CRR) and 25 patients underwent surgery only (RO). The study was non-randomised. Patients were identified from a prospective database.

RESULTS: The median survival time was 30.2 mo in the CRR group and 35.9 mo in the RO group. No statistically significant differences were found in subclasses according to lymph node involvement, TNM stages, tumor size, or perineural invasion. The one, three and five year survival rates were 81%, 33% and 33%, respectively, in the CRR group and 72%, 47% and 23%, respectively, in the RO group. In ductal adenocarcinoma, the median survival time was 27 mo in the CRR group and 20 mo in the RO group. No statistically significant differences were found in the above subclasses. The one, three and five year survival rates were 79%, 21% and 21%, respectively, in the CRR group and 64%, 50% and 14%, respectively, in the RO group. The overall hospital mortality rate was 2%. The morbidity rate was 45% in the CRR group and 32% (NS) in the RO group.

CONCLUSION: Major multicenter randomized studies are needed to conclusively assess the impact of neoadjuvant treatment in the management of pancreatic cancer.

Keywords: Pancreatic cancer; Neoadjuvant; Chemo-radiation; Gemcitabine