BACKGROUND: The feasibility and anti-tumor activity of gemcitabine in postoperative adjuvant chemotherapy were evaluated retrospectively. PATIENTS AND METHODS: Sixteen patients with advanced pancreatic cancer, who had a pancreatic resection with curative intent over the three years up to February 2003, were enrolled in this study. Aggressive surgery with dissection of para-aortic nodes and nerves around the superior mesenteric and celiac artery was carried out. After the operation, all patients have been given biweekly administration of 1,000 mg/m2 gemcitabine for more than 12 courses. RESULTS: The chemotherapy was well tolerated with only mild symptomatic and hematologic toxicities. Grade 3 adverse effects were observed in only 3 patients (19%); nausea and vomiting in 1 patient and leucocytopenia in 2 patients. The disease-specific cumulative survival rates were 81% at 1 year and 47% at 2 years, with a median survival of 20.4 months. The median disease-free interval was 16.8 months in all patients. CONCLUSIONS: Adjuvant systemic chemotherapy utilizing gemcitabine was feasible with acceptable adverse effects. Gemcitabine is a promising agent for the treatment of resectable advanced pancreatic cancer, and a randomized control trial is warranted for gemcitabine-based chemotherapy.
BACKGROUND: The feasibility and anti-tumor activity of gemcitabine in postoperative adjuvant chemotherapy were evaluated retrospectively. PATIENTS AND METHODS: Sixteen patients with advanced pancreatic cancer, who had a pancreatic resection with curative intent over the three years up to February 2003, were enrolled in this study. Aggressive surgery with dissection of para-aortic nodes and nerves around the superior mesenteric and celiac artery was carried out. After the operation, all patients have been given biweekly administration of 1,000 mg/m2 gemcitabine for more than 12 courses. RESULTS: The chemotherapy was well tolerated with only mild symptomatic and hematologic toxicities. Grade 3 adverse effects were observed in only 3 patients (19%); nausea and vomiting in 1 patient and leucocytopenia in 2 patients. The disease-specific cumulative survival rates were 81% at 1 year and 47% at 2 years, with a median survival of 20.4 months. The median disease-free interval was 16.8 months in all patients. CONCLUSIONS: Adjuvant systemic chemotherapy utilizing gemcitabine was feasible with acceptable adverse effects. Gemcitabine is a promising agent for the treatment of resectable advanced pancreatic cancer, and a randomized control trial is warranted for gemcitabine-based chemotherapy.