Nedim Turan1, Mustafa Benekli1, Olcun Umit Unal1, İlkay Tugba Unek1, Didem Tastekin1, Faysal Dane1, Efnan Algın1, Sukran Ulger1, Tulay Eren1, Turkan Ozturk Topcu1, Esma Turkmen1, Nalan Akgül Babacan1, Gulnihal Tufan1, Zuhat Urakci1, Basak Oven Ustaalioglu1, Ozlem Sonmez Uysal1, Ozlem Balvan Ercelep1, Burcu Yapar Taskoylu1, Asude Aksoy1, Mustafa Canhoroz1, Umut Demirci1, Erkan Dogan1, Veli Berk1, Ozan Balakan1, Ahmet Şiyar Ekinci1, Mukremin Uysal1, İbrahim Petekkaya1, Selçuk Cemil Ozturk1, Önder Tonyalı1, Bülent Çetin1, Mehmet Naci Aldemir1, Kaan Helvacı1, Nuriye Ozdemir1, İlhan Oztop1, Ugur Coskun1, Aytug Uner1, Ahmet Ozet1, Suleyman Buyukberber1. 1. 1 Department of Medical Oncology, Faculty of Medicine, Cumhuriyet University, Sivas 58140, Turkey ; 2 Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey ; 3 Department of Medical Oncology, Faculty of Medicine, Dokuz EylulUniversity, Izmir 35340, Turkey ; 4 Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya 42080, Turkey ; 5 Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul 34000, Turkey ; 6 Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara 06560, Turkey ; 7 Department of Medical Oncology, Numune Education and Research Hospital, Ankara 06100 Turkey ; 8 Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61000, Turkey ; 9 Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22020, Turkey ; 10 Department of Medical Oncology, Rize Education and Research Hospital, Rize 53200, Turkey ; 11 Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir 21280, Turkey ; 12 Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul 34668, Turkey ; 13 Department of Medical Oncology, Sakarya Education and Research Hospital, Sakarya 54050, Turkey ; 14 Department of MedicalOncology, Faculty of Medicine, Pamukkale University, Denizli 20070, Turkey ; 15 Department of Medical Oncology, Faculty of Medicine, Inonu University, Malatya 44315, Turkey ; 16 Department of Medical Oncology, Faculty of Medicine, Firat University, Elazig 23200, Turkey ; 17 Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Education and Research Hospital, Ankara 06200, Turkey ; 18 Department of Medical Oncology, Faculty of Medicine, Yuzuncu Yil University, Van 65080, Turkey ; 19 Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri 38000, Turkey ; 20 Department of Medical Oncology, Faculty of Medicine, SutcuImam Univer
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.
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.
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