CHICAGO (February 16, 2016) -- AMERICAN COLLEGE OF SURGEONS: Patients who received chemotherapy after surgical resection of pancreatic cancer have fewer distant disease recurrences and longer overall survival than those who also had adjuvant chemoradiation therapy. While a course of radiotherapy in addition to chemotherapy and a cancer operation reduced the number of local disease recurrences, it did not affect distant recurrences or survival. Findings from the first multicenter clinical trial to relate disease recurrence patterns to the type of adjuvant therapy indicate that patients should receive a full course of chemotherapy rather than chemoradiotherapy following surgical treatment for pancreatic cancer.

The study, published online in the Journal of the American College of Surgeons in advance of print publication, evaluated survival and disease recurrence in 1,130 patients who underwent successful surgical resection for pancreatic cancer between January 2000 and December 2010. Most patients had grade 2, Stage II disease (grade 4, Stage IV is the most advanced), and they received no treatment for cancer prior to surgery. Alexander A. Parikh, MD, MPH, FACS, Associate Professor of Surgery at Vanderbilt University, Nashville, Tenn., led the study; its results were presented at the Southern Surgical Association meeting in Hot Springs, Virginia, in December 2015.

Pancreatic cancer is the fourth most common cause of cancer death in the United States, according to the Centers of Disease Control and Prevention (CDC), with an estimated 48,960 new cases per year. Although surgical resection offers a potential cure, most patients have locally advanced or metastatic disease at diagnosis. Consequently, only 10 to 15 percent of patients are candidates for a potentially curative operation. Even among patients whose disease has been successfully resected, recurrence is common. Between 50 and 90 percent of patients have recurrences, and most of these patients die because of their disease.*
Because of the high incidence of disease recurrence, adjuvant therapy is given routinely after surgery for pancreatic cancer. Adjuvant therapy typically involves systemic chemotherapy given with or without chemoradiotherapy. A six-month course of chemotherapy is considered to be standard. The role of adjuvant chemoradiation, however, is often used at the discretion of the treating physician, and is usually recommended for patients who have signs of local disease advancement, such as positive lymph nodes or positive surgical margins.

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