World Journal of Surgery

, Volume 38, Issue 11, pp 2986–2993 | Cite as

S-1 vs. Gemcitabine as an Adjuvant Therapy after Surgical Resection for Ductal Adenocarcinoma of the Pancreas

  • Takehiro Okabayashi
  • Yasuo Shima
  • Jun Iwata
  • Sojiro Morita
  • Tatsuaki Sumiyoshi
  • Akihito Kozuki
  • Teppei Tokumaru
  • Tatsuo Iiyama
  • Takuhiro Kosaki
  • Michiya Kobayashi
  • Kazuhiro Hanazaki
Original Scientific Report



Pancreatectomy with regional lymphadenectomy remains the only curative treatment option for pancreatic cancer. There is no clear consensus on what type of adjuvant therapy should be used for patients with pancreatic cancer.


Our objective was to retrospectively evaluate whether postoperative adjuvant chemotherapy using S-1 is clinically beneficial in managing resectable pancreatic cancer.


Patients were divided into three groups: those undergoing surgery alone, those receiving gemcitabine infusion, and those receiving S-1 orally.


Of 189 studied patients, the median overall survival was 15.0 months after surgery alone, 33.0 months in the gemcitabine group, and 45.0 months in patients receiving S-1. A multivariate analysis identified regional lymph node metastasis, positive surgical margins, and absence of adjuvant chemotherapy as independent negative prognostic factors. S-1 was not inferior to gemcitabine in terms of survival outcomes and showed a favorable hazard ratio compared with gemcitabine in the subsets of patients with positive vascular invasion.


There was no difference between adjuvant chemotherapy with S-1 and gemcitabine in overall survival for patients with curative pancreatic cancer. Our results suggested that S-1 can be used as a second agent to gemcitabine after surgical resection for ordinary adenocarcinoma of the pancreas.



This work was supported by the Kochi Organization for Medical Reformation and Renewal Grants.

Conflict of interest

The authors state that there are no conflicts of interest or financial disclosures.


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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Takehiro Okabayashi
    • 1
  • Yasuo Shima
    • 1
  • Jun Iwata
    • 2
  • Sojiro Morita
    • 3
  • Tatsuaki Sumiyoshi
    • 1
  • Akihito Kozuki
    • 1
  • Teppei Tokumaru
    • 1
  • Tatsuo Iiyama
    • 4
  • Takuhiro Kosaki
    • 5
  • Michiya Kobayashi
    • 6
  • Kazuhiro Hanazaki
    • 6
  1. 1.Department of Gastroenterological SurgeryKochi Health Sciences CenterKochi-CityJapan
  2. 2.Department of Diagnostic PathologyKochi Health Sciences CenterKochi-CityJapan
  3. 3.Department of RadiologyKochi Health Sciences CenterKochi-CityJapan
  4. 4.Department of BiostatisticsKochi Medical SchoolKochi-CityJapan
  5. 5.Department of Gastroenterology and HepatologyKochi Medical SchoolKochi-CityJapan
  6. 6.Department of SurgeryKochi Medical SchoolKochi-CityJapan

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