ADJUVANT THERAPIES IN EXTENDED PANCREATECTOMY FOR DUCTAL ADENOCARCINOMA OF THE PANCREAS

BACKGROUND/AIMS: The poor prognosis after pancreatic cancer resection is attributed to a high incidence of locoregional recurrence and hepat ic metastasis. The present study was carried out in order to determine whether adjuvant therapies improve patient survival. METHODOLOGY: Pre operative irradiation and postoperative liver perfusion chemotherapy h ave been added to the extended pancreatectomy procedure, and a retrosp ective analysis of 111 patients was performed. RESULTS: Preoperative i rradiation (n=17) significantly decreased the incidence of locoregiona l recurrence but increased the incidence of hepatic metastasis, with n o improvement in the 5-year survival rate (from 27% to 23%). In contra st, postoperative liver perfusion chemotherapy (n=27) succeeded in imp roving the 5-year survival rate to 39% by significantly decreasing the incidence of hepatic metastasis. CONCLUSION: These data suggest that the patients' survival rate may be increased when these two types of a djuvant therapy are combined with extended pancreatectomy.