A team from Philadelphia, Pennsylvania, USA, determined the long-term survival of patients with pancreatic adenocarcinoma who underwent surgical resection. They also assessed the association of clinical, pathological, and treatment features with survival.
Between 1990 and 1998, 125 patients underwent a pancreaticoduodenal or partial pancreatic resection for pancreatic ductal adenocarcinoma, at the University of Pennsylvania Cancer Center.
The records of all patients were reviewed for demographics, tumor characteristics (including size, histological grade, margin status, lymph node status, and surgical TNM staging), and postoperative adjuvant therapy.
A total of 116 patients, who had a complete follow-up, were included in the final analysis.
The median survival after surgery was found to be 16 months.
The 1-, 3-, 5-, and 7-year survival rates for all 116 patients were 60%, 23%, 19%, and 11%, respectively.
For patients who received adjuvant therapy, the survival rates were 69%, 28%, 23%, and 18%, respectively. This was compared with 20% and 0% in patients who did not receive adjuvant therapy.
|7-year survival rates after pancreatic carcinoma resection:|
All patients: 11%
With adjuvant therapy: 18%
Without adjuvant therapy: 0%
| American Journal of Gastroenterology |
The 1-, 3-, 5-, and 7-year survival rates for patients with negative lymph nodes were 73%, 38%, 26%, and 22%, compared with survival rates of 52%, 14%, 14%, and 9% in patients with positive lymph nodes.
The researchers found that, in multivariate analyses, adjuvant therapy was the only feature found to be strongly associated with survival (hazards ratio = 0.26).
Author N. A. Ahmad concluded on behalf of the group, "The overall 5- and 7-year survival rates were 19% and 11% in our study.
"These results further validate that surgical resection in patients with pancreatic adenocarcinoma can result in long-term survival, particularly when performed in association with adjuvant chemoradiation."
In an accompanying editorial, Dr Douglas Tyler, of the Duke University Medical Center, Durham, North Carolina, cautions that pancreatic cancer cannot be cured surgically.
In reality, pancreatic cancer is a systemic disease by the time it is diagnosed with current imaging techniques. Surgery is a modality that cures patients when disease is localized.
However, Dr Tyler commends the fact that the researchers administered postoperative chemoradiation therapy to such a high proportion of the patients.
He adds that developing better chemotherapy combinations, enhancing chemotherapy and radiation interactions, and continuing to optimize surgical outcomes will be the target of short-term studies.