Oncological problems in pancreatic cancer surgery

doi:10.3748/wjg.v12.i28.4466

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jul 28, 2006; 12(28): 4466-4472
Published online Jul 28, 2006. doi: 10.3748/wjg.v12.i28.4466

Table 3 Randomised controlled trials of adjuvant treatment for pancreatic ductal adenocarcima

Trial	Comparison	Adjuvant treatment	Number of patients	Conclusions
GITSG, 1985[58], 1987[59]	CRT vs OBS	2 × (20 Gy in 10 fractions + 500 mgm^-2 5FU d 1-3) + weekly 5FU to recurrence	49 pancreatic patients randomised	Significant increase in median survival (20 vs 11 mo, P = 0.035) in 43 eligible patients
Norway, 1993[60]	CT vs OBS	AMF (40 mgm^-2 doxorubicin, 6 mgm^-2 mytomycin C, 500 mgm^-2 5FU) once every 3 wk for six courses	61 patients (47 pancreatic, 14 ampullary) randomised 46 additional nonrandomised patients	Significant increase in median survival (23 vs 11 mo, P = 0.02) in 60 pancreatic and ampullary patients combined
EORTC, 1999[61]	CRT vs OBS	2 × (20 Gy in 10 fractions + 25 mgkg^-1 5FU/FA d 1-5)	218 patients (120 pancreatic, 93 ampullary) randomised	NS increase in median survival (25 vs 19 mo, P = 0.21) in 207 eligible patients NS increase in median survival in 114 eligible pancreatic patients (17 vs 13 mo, P = 0.099)
Japan, 2002[62]	CT vs OBS	6 mgm^-2 mytomycin C d 1 + 310 mgm^-2 5FU d 1-5 and d 15-20 followed by 100 mgm^-2 oral 5FU daily until recurrence	508 patients (173 pancreatic, 335 bile duct/gallbladder/ampullary) randomised	Significant survival benefit in gallbladder No difference in 158 eligible pancreatic patients No difference in 48 eligible ampullary patients
ESPAC1, 2001[63], 2004[64]	CRT vs no CRT CT vs no CT	2 × (20 Gy in 10 fractions + 500 mgm^-2 5FU/FA d 1-3)(20 mgm^-2 FA + 425 mgm^-2 5FU d 1-5) × six cycles	289 pancreatic patients randomised	NS decrease in survival for CRT (P = 0.05) in 289 patients Significant increase in survival for CT (P = 0.009) in 289 eligible patients
CONKO-001, 2005[65]	CT vs OBS	1 gm^-2 GEM, d 1, 8, 15, every 4 wk for 6 mo	368 pancreatic patients randomised	Significant increase in median DFS (14.2 vs 7.5 mo, P < 0.05) in 356 eligible patients

CRT: Chemoradiotherapy; CT: Chemotherapy; OBS: Observation; NS: Not significant; DFS: Disease-free survival.

Citation: Nakao A, Fujii T, Sugimoto H, Kanazumi N, Nomoto S, Kodera Y, Inoue S, Takeda S. Oncological problems in pancreatic cancer surgery. World J Gastroenterol 2006; 12(28): 4466-4472
URL: https://www.wjgnet.com/1007-9327/full/v12/i28/4466.htm
DOI: https://dx.doi.org/10.3748/wjg.v12.i28.4466