Skip to main content

Progress by Collaboration: ESPAC Studies

  • Chapter
Pancreatic Disease

Abstract

Pancreatic cancer is amongst the top ten fatal cancers of the Western world, accounting for 57 000 deaths per year in Europe and 29 000 deaths per year in the United States.1 It is particularly difficult to treat because of its inaccessible location, late presentation, and frequently aggressive tumour biology. Five-year survival in the 10–15% of affected patients who undergo potentially curative surgery is limited to 17–24%,2,3 whilst overall 5-year survival in all patients is less than 0.5%.4 Although significant improvements in surgical outcome have been obtained with increasing specialisation and case-load,3,5 and further benefits may be anticipated with earlier investigation and referral of high risk groups, 6 the role of adjuvant and neo-adjuvant treatment accompanying surgery remains uncertain.7-10 Interestingly, chemotherapy is the principal modality in the treatment of advanced pancreatic cancer.11

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Parkin DM, Muir CS, Whelan SL, et al. Cancer incidence in five continents, vol VI. Lyon: International Agency for Research on Cancer, 1992 (IARC Scientific Publications number 120)

    Google Scholar 

  2. Nitecki SS, Sarr MG, Colby, et al. Long-term survival after resection for ductal adenocarcinoma of the pancreas: is it really improving? Ann Surg 1995; 221:59–66

    Article  PubMed  CAS  Google Scholar 

  3. Birkmeyer JD, Warshaw AL, Finlayson STG, et al. Relationship between hospital volume and late survival after pancreatoduodenectomy. Surgery 1999; 126:178–183

    Article  PubMed  CAS  Google Scholar 

  4. Bramhall SR, Allum WH, Jones AG, et al. Incidence, treatment and survival in 13,560 patients with pancreatic cancer: an epidemiological study in the West Midlands. Br J Surg 1995; 82:111–115

    Article  PubMed  CAS  Google Scholar 

  5. Neoptolemos JP, Russell RCG, Bramhall SR, et al. Low mortality following resection for pancreatic and periampullary tumours in 1026 patients: UK survey of specialist pancreatic units. Br J Surg 1997; 84:1370–1376

    Article  PubMed  CAS  Google Scholar 

  6. Wong T, Howes N, Threadgold J, et al. Molecular diagnosis of pancreatic ductal adenocarcinoma in high-risk patients. Pancreatology 2001; 1:486–509

    Article  PubMed  CAS  Google Scholar 

  7. Kalser MH, Ellenberg SS. Pancreatic cancer: adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 185; 120:899–903

    Google Scholar 

  8. Douglass HO. Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Cancer 1987; 59:2006–2010

    Article  Google Scholar 

  9. Bakkevold KE, Arnesjo B, Dahl O, et al. Adjuvant combination chemotherapy (AMF) following radical resection of carcinoma of the pancreas and papilla of Vater: results of a controlled, prospective, randomised multicenter study. Eur J Cancer 1993; 5:698–703

    Article  Google Scholar 

  10. Klinkenbijl JH, Jeekel J, Sahmoud T, et al. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region. Phase III trial of the EORTC Gastrointestinal Tract Cancer Cooperative Group. Ann Surg 1999; 230:776–784

    Article  PubMed  CAS  Google Scholar 

  11. Magee CJ, Ghaneh P, Neoptolemos JP. Surgical and medical therapy for pancreatic carcinoma. Best Pract Res Clin Gastroenterol 2002; 16:435–55

    Article  PubMed  Google Scholar 

  12. Jones L, Mosca F, Russell C, et al. Standard Kausch-Whipple pancreatoduodenectomy. Dig Surg 1999; 16:297–304

    Article  PubMed  CAS  Google Scholar 

  13. Pedrazzoli S, Di Carlo V, Dionigi R, et al. Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a Multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg 1998; 228:508–517

    Article  PubMed  CAS  Google Scholar 

  14. Mosca F, Giulianotti PC, Balestracci T, et al. Long-term survival in pancreatic cancer: pyloruspreserving vs Whipple pancreatoduodenectomy. Surgery 1997; 122:553–566

    Article  PubMed  CAS  Google Scholar 

  15. Trede M, Schwall G, Saeger H-D. Survival after pancreatoduodenectomy: 118 consecutive resections without an operative mortality. Ann Surg 1990; 211:447–458

    Article  PubMed  CAS  Google Scholar 

  16. Allema JH, Reinders ME, Vangulik TM, et al. Prognostic factors for survival after pancreaticoduodenectomy for patients with carcinoma of the pancreatic head region. Cancer 1995; 75:2069–2076

    Article  PubMed  CAS  Google Scholar 

  17. Yeo C, Abrams R, Grochow L, et al. Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival: a prospective, single institution experience. Ann Surg 1997; 225:621–633

    Article  PubMed  CAS  Google Scholar 

  18. Snow J. On the mode of communication of cholera. 2nd edn. London: John Churchill, 1860 (facsimile of 1936 reprinted edition published in 1965 by Hafner, New York)

    Google Scholar 

  19. Streptomycin in Tuberculosis Trials Committee, Medical Research Council. Streptomycin treatment in pulmonary tuberculosis: a Medical Research Council investigation. BMJ 1948; ii:769–82

    Google Scholar 

  20. van der Wijden CL, Overbeke JA. Audit of reports of randomised clinical trials published in one journal over 45 years. BMJ 1995; 311:918

    Article  PubMed  Google Scholar 

  21. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. Lancet 2001; 357:1191–4

    Article  PubMed  CAS  Google Scholar 

  22. Moher D, Jones A, Lepage L, et al. Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. JAMA 2001; 285:1992–1995

    Article  PubMed  CAS  Google Scholar 

  23. Peto R, Baigent C. Trials: the next 50 years. Large scale randomised evidence of moderate benefits. BMJ 1998; 317:1170–1

    Article  PubMed  CAS  Google Scholar 

  24. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction. Lancet 1988; ii:349–360

    Google Scholar 

  25. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17:1–12

    Article  PubMed  CAS  Google Scholar 

  26. Neoptolemos JP, Dunn JA, Stocken DD, et al. European Study Group for Pancreatic Cancer. Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet 2001; 358:1576–85

    Article  PubMed  CAS  Google Scholar 

  27. Neoptolemos JP, Stocken DD, Dunn JA, et al. European Study Group for Pancreatic Cancer. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg 2001; 234:758–68

    Article  PubMed  CAS  Google Scholar 

  28. Link KH, Formentini A, Leder G, et al. Resection and radiochemotherapy of pancreatic cancer — the future? Langenbecks Arch Surg 1998; 383:134–144

    Article  PubMed  CAS  Google Scholar 

  29. Abbruzzese JL. Past and present treatment of pancreatic adenocarcinoma: chemotherapy as a standard treatment modality. Semin Oncol 2002; 29:2–8

    PubMed  CAS  Google Scholar 

  30. Neoptolemos JP, Cunningham D, Friess H, et al. Adjuvant therapy in pancreatic cancer: historical and current perspectives. Ann Oncol 2003; 14:675–92

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag London

About this chapter

Cite this chapter

Sutton, R. et al. (2004). Progress by Collaboration: ESPAC Studies. In: Pancreatic Disease. Springer, London. https://doi.org/10.1007/978-1-85233-904-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-85233-904-3_5

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-3491-6

  • Online ISBN: 978-1-85233-904-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics