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The effect of adjuvant and neoadjuvant chemo(radio)therapy on survival in 1,679 resected pancreatic carcinoma cases in Japan: report of the national survey in the 34th annual meeting of Japanese Society of Pancreatic Surgery

Journal of Hepato-Biliary-Pancreatic Surgery volume 16, pages 485–492 (2009)Cite this article

Abstract

Background

Pancreatic carcinoma causes more than 20,000 deaths every year in Japan. The role of (neo-) adjuvant chemotherapy for pancreatic carcinoma is still controversial.

Methods

At the 34th Annual Meeting of the Japanese Society of Pancreatic Surgery in 2007, questionnaires were distributed regarding the use of (neo-) adjuvant chemo(radio)therapy for pancreatic carcinoma between 2001 and 2005.

Results

Sixty of the 146 member institutions responded to the questionnaires. There were a total of 1,846 cases of resected pancreatic carcinoma between 2001 and 2005. The study population had a greater proportion of males, and a mean age of 65.3 years (range 34–90 years). The lesion was located in the head of the pancreas in 1,204 cases (71.7%), in the body in 353 cases (21.0%), and in the tail in 111 cases (6.6%). Overall survival rates were 67.3% at 1 year, 36.0% at 2 years, and 23.9% at 3 years, respectively. Adjuvant chemotherapy (usually involving gemcitabine) was used in 66.0% of cases. The use of adjuvant chemotherapy was found to improve the overall survival rate. Interestingly, adjuvant chemotherapy only improved survival in late-stage (UICC stages IIB, III, and IV) but not early stage (IA, IB, and IIA) patients. Survival was treatment duration-dependent, with patients who received more than 12 months of therapy having a 3-year survival rate of 51.2%.

Conclusion

This high volume retrospective data indicated the promising effect of gemcitabine-based adjuvant chemotherapy and the rational duration of adjuvant chemotherapy should be determined in the future prospective studies.

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Acknowledgments

The authors are especially grateful to the 60 leading Japanese institutions that kindly took part in the survey.

Aichi Medical University, Department of Surgery; Division of Gastroenterol Surgery

Asahikawa Medical College, Department of Gastroenterological Surgery

Chiba Cancer Center, Department of Gastroenterological Surgery

Chiba Rosai Hospital, Department of Surgery

Fujita Health University School of Medicine, Department of Biliary Pancreatic Surgery

Fukui University, Faculty of Medicine, Department of Surgery I

Higashiosaka City General Hospital, Department of Surgery

Hirosaki University School of Medicine, Department of Surgery II

Hiroshima City Hospital, Department of Surgery

Hyogo College of Medicine, Department of Surgery 1

Ikuwakai Memorial Hospital, Department of Surgery

Ise Municipal General Hospital, Department of Surgery

Iwate Medical University School of Medicine, Department of Surgery

Jichi Medical University, Department of Surgery

Jikei University School of Medicine, Department of Surgery

Jikei University School of Medicine, Aoto Hospital, Department of Surgery

Jikei University, Daisan Hospital, Department of Surgery

Jikei University, Kashiwa Hospital, Department of Surgery

Kagawa University, Faculty of Medicine, Department of Gastroenterological Surgery

Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Department of Surgery

Kitakyushu Municipal Medical Center, Department of Surgery

Kitasato University School of Medicine, Department of Surgery

Kobe City Medical Center General Hospital, Department of Surgery

Kobe University Graduate School of Medicine, Department of Hepato-Billiary-Pancreatic Surgery

Kurume University School of Medicine, Department of Surgery

Kyorin University School of Medicine, Department of Surgery

Kyushu University, Faculty of Medicine, Department of Surgery I

Matsusaka City Hospital, Department of Surgery

Meiwa Hospital, Department of Surgery

Miyazaki University School of Medicine, Department of Surgical Oncology and Regulation of Organ Function

Nagasaki University Graduate School of Medicine, Department of Gastroenterological Surgery

Nagoya City University Graduate School of Medical Sciences, Department of Gastroenterological Surgery

Nagoya University Graduate School of Medicine, Department of Gastroenterological Surgery

Nara Medical University, Department of Surgery

National Cancer Center Hospital East, Department of Upper Abdominal Surgery

National Kyushu Cancer Center, Department of Surgery

National Kyushu Medical Center, Department of Surgery

Nihon University School of Medicine, Division of Digestive Surgery

Niigata Prefectural Central Hospital, Department of Surgery

Niigata University School of Medicine, Department of Surgery

Nippon Medical School, Department of Surgery I

Okayama University Graduate School of Medicine, Department of Gastroenterological surgery transplant and Surgical Oncology

Osaka City University Graduate School of Medicine, Department of Hepato-Billiary-Pancreatic Surgery

Osaka City University Graduate School of Medicine, Department of Surgical Oncology

Osaka Rosai Hospital, Department of Surgery

Osaka University Graduate School of Medicine, Department of Gastroentelogical Surgery

Sapporo Medical University, Department of Surgery I

Sapporo-Kosei general Hospital, Department of Surgery

Shinshu University School of Medicine, Department of Surgery

Showa University School of Medicine, Department of Surgery

St. Marianna University School of Medicine, Department of Surgery

St. Marianna University, Yokohama City Seibu Hospital, Department of Surgery

Teikyo University Chiba Medical Center, Department of Surgery

Tochigi Cancer Center, Department of Surgery

Toho University Ohashi Medical Center, Department of Surgery III

Tokyo Medical University, Department of Surgery

Tokyo Women’s Medical University Medical Center East, Department of Surgery

Tokyo Women’s Medical University, Institute of Gastroenterology, Department of Gastroenterological Surgery

Wakayama Medical University, Department of Gastroenterological Surgery

Yamaguchi University Graduate School of Medicine, Department of Digestive Surgery and Surgical Oncology.

Author information

Affiliations

  1. Department of Surgery, Jichi Medical University, Tochigi, Japan

    Naohiro Sata, Kentaro Kurashina & Hideo Nagai

  2. Japanese Society of Pancreatic Surgery, Tokyo, Japan

    Takukazu Nagakawa, Osamu Ishikawa, Tetsuo Ohta, Masaaki Oka, Hisafumi Kinoshita, Wataru Kimura, Hiroshi Shimada, Masao Tanaka, Akimasa Nakao, Kouichi Hirata & Hideki Yasuda

  3. Division of Endoscopic Surgery, Department of Gastroenterological and General Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Naohiro Sata

Authors
  1. Naohiro Sata
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  2. Kentaro Kurashina
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  3. Hideo Nagai
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Correspondence to Naohiro Sata.

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Sata, N., Kurashina, K., Nagai, H. et al. The effect of adjuvant and neoadjuvant chemo(radio)therapy on survival in 1,679 resected pancreatic carcinoma cases in Japan: report of the national survey in the 34th annual meeting of Japanese Society of Pancreatic Surgery. J Hepatobiliary Pancreat Surg 16, 485–492 (2009). https://doi.org/10.1007/s00534-009-0077-7

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  • DOI: https://doi.org/10.1007/s00534-009-0077-7

Keywords

  • Pancreatic carcinoma
  • Adjuvant chemotherapy
  • Gemcitabine
  • Japanese Society of Pancreatic Surgery