Cancer Chemotherapy and Pharmacology

, Volume 71, Issue 2, pp 419–429

Early initiation of adjuvant chemotherapy improves survival of patients with pancreatic carcinoma after surgical resection

  • Yoshiaki Murakami
  • Kenichiro Uemura
  • Takeshi Sudo
  • Yasushi Hashimoto
  • Naru Kondo
  • Naoya Nakagawa
  • Hayato Sasaki
  • Taijiro Sueda
Original Article

DOI: 10.1007/s00280-012-2029-1

Cite this article as:
Murakami, Y., Uemura, K., Sudo, T. et al. Cancer Chemother Pharmacol (2013) 71: 419. doi:10.1007/s00280-012-2029-1

Abstract

Purpose

Adjuvant chemotherapy is accepted as a standard treatment after surgical resection of pancreatic carcinoma; however, the optimal timing between surgery and initiation of adjuvant chemotherapy has not been reported. The aim of this study was to determine the optimal timing of adjuvant chemotherapy after surgical resection of pancreatic carcinoma.

Methods

Records of 104 patients who received adjuvant chemotherapy after curative surgical resection of pancreatic carcinoma were reviewed retrospectively. Patients were grouped according to whether they received initial adjuvant chemotherapy within 20 days after surgery (≦20 days, n = 57) or more than 20 days after surgery (>20 days, n = 47). Relationships between time to initiation of adjuvant chemotherapy, other clinicopathological factors, and survival were analyzed.

Results

The rate of postoperative complication was significantly lower than in the ≦20 days group compared with the >20 days group (P = 0.003); no significant difference in other clinicopathological factors was found. Multivariate analysis revealed that time to initiation of adjuvant chemotherapy was an independent prognostic factor of disease-free survival (P = 0.009) and overall survival (P = 0.037). The ≦20 days group had longer 5-year overall survival rates than did the >20 days group (52 vs. 26 %, P = 0.013) as well as longer 5-year disease-free survival rates (53 vs. 22 %, P = 0.007).

Conclusions

Adjuvant chemotherapy for patients with resected pancreatic carcinoma should be initiated as soon as possible after surgical resection. Prevention of postoperative complication is needed to enable early initiation.

Keywords

Pancreatic carcinoma Adjuvant chemotherapy Time to initiation Survival Postoperative complication 

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Yoshiaki Murakami
    • 1
  • Kenichiro Uemura
    • 1
  • Takeshi Sudo
    • 1
  • Yasushi Hashimoto
    • 1
  • Naru Kondo
    • 1
  • Naoya Nakagawa
    • 1
  • Hayato Sasaki
    • 1
  • Taijiro Sueda
    • 1
  1. 1.Department of Surgery, Institute of Biomedical and Health SciencesHiroshima UniversityMinami-kuJapan

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