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Clinical Study

The Role of Adjuvant Chemotherapy for Patients with Resected Pancreatic Cancer: Systematic Review of Randomized Controlled Trials and Meta-Analysis

Boeck S.a · Ankerst D.P.b · Heinemann V.a

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aDepartment of Internal Medicine III, Klinikum Grosshadern and bInstitute for Medical Informatics, Biometry and Epidemiology, Ludwig Maximilians University of Munich, Munich, Germany

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Oncology 2007;72:314–321

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 13, 2007
Accepted: August 13, 2007
Published online: January 14, 2008
Issue release date: February 2008

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)

For additional information: http://www.karger.com/OCL

Abstract

Background: In patients undergoing surgery for resectable pancreatic cancer prognosis still remains poor. The role of adjuvant treatment strategies (including chemotherapy and chemoradiotherapy) following resection of pancreatic cancer remains controversial. Methods: A Medline-based literature search was undertaken to identify randomized controlled trials that evaluated adjuvant chemotherapy after complete macroscopic resection for cancer of the exocrine pancreas. Five trials of adjuvant chemotherapy were eligible and critically reviewed for this article. A meta-analysis (based on published data) was performed with survival (median survival time and 5-year survival rate) being the primary endpoint. Results: For the meta-analysis, 482 patients were allocated to the chemotherapy group and 469 patients to the control group. The meta-analysis estimate for prolongation of median survival time for patients in the chemotherapy group was 3 months (95% CI 0.3–5.7 months, p = 0.03). The difference in 5-year survival rate was estimated with 3.1% between the chemotherapy and the control group (95% CI –4.6 to 10.8%, p > 0.05). Conclusion: Currently available data from randomized trials indicate that adjuvant chemotherapy after resection of pancreatic cancer may substantially prolong disease-free survival and cause a moderate increase in overall survival. In the current meta-analysis, a significant survival benefit was only seen with regard to median survival, but not for the 5-year survival rate. The optimal chemotherapy regimen in the adjuvant setting as well as individualized treatment strategies (also including modern chemoradiotherapy regimens) still remain to be defined.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 13, 2007
Accepted: August 13, 2007
Published online: January 14, 2008
Issue release date: February 2008

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)

For additional information: http://www.karger.com/OCL


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