Adjuvant therapy following resection for pancreatic adenocarcinoma.

Pancreatic adenocarcinoma remains a lethal disease. Approximately 10% to 15% of patients who are able to undergo resection will be alive at 5 years, but most of those will have late recurrence and ultimately die of the disease. Multiple adjuvant treatments have been tested, including extended operations, chemotherapy, radiation therapy, and immunotherapy--the vast majority with minimal, if any, effect. There is a small suggested benefit from adjuvant chemotherapy but little other cause for optimism. At the current time, given the relative failure of standard adjuvant approaches, it is reasonable to suggest that all patients should have tissue harvested for molecular markers and enter into investigative regimens.