Original Article on Pancreatic Cancer

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma

Nedim Turan, Mustafa Benekli, Olcun Umit Unal, İlkay Tugba Unek, Didem Tastekin, Faysal Dane, Efnan Algın, Sukran Ulger, Tulay Eren, Turkan Ozturk Topcu, Esma Turkmen, Nalan Akgül Babacan, Gulnihal Tufan, Zuhat Urakci, Basak Oven Ustaalioglu, Ozlem Sonmez Uysal, Ozlem Balvan Ercelep, Burcu Yapar Taskoylu, Asude Aksoy, Mustafa Canhoroz, Umut Demirci, Erkan Dogan, Veli Berk, Ozan Balakan, Ahmet Şiyar Ekinci, Mukremin Uysal, İbrahim Petekkaya, Selçuk Cemil Ozturk, Önder Tonyalı, Bülent Çetin, Mehmet Naci Aldemir, Kaan Helvacı, Nuriye Ozdemir, İlhan Oztop, Ugur Coskun, Aytug Uner, Ahmet Ozet, Suleyman Buyukberber, Anatolian Society of Medical Oncology (ASMO)

Abstract

Background: We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC).
Methods: A total of 563 patients who were curatively resected for PAC were retrospectively analyzed between 2003 and 2013.
Results: Of 563 patients, 472 received adjuvant chemotherapy (CT) alone, chemoradiotherapy (CRT) alone, and chemoradiotherapy plus chemotherapy (CRT-CT) were analyzed. Of the 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence-free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. When CT and CRT-CT groups were compared, there was no significant difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT groups. To further investigate the impact of radiation on subgroups, patients were stratified according to lymph node status and resection margins. In node-positive patients, both RFS and OS were significantly longer in CRT-CT than CT. In contrast, there was no significant difference between groups when patients with node-negative disease or patients with or without positive surgical margins were considered.
Conclusions: Addition of radiation to CT has a survival benefit in patients with node-positive disease following pancreatic resection.