Affiliation:
1. Department of Surgery Keio University School of Medicine Tokyo Japan
2. Department of Surgery Kawasaki Municipal Hospital Kawasaki Japan
3. Department of Surgery Ashikaga Red Cross Hospital Tochigi Japan
4. Department of Surgery Tokyo Dental College Ichikawa General Hospital Chiba Japan
5. Department of Surgery Tachikawa Kyosai Hospital Tokyo Japan
6. Department of Surgery Kitasato Institute Hospital Tokyo Japan
7. Department of Surgery Isehara Kyodo Hospital Kawasaki Kanagawa Japan
8. Digestive Diseases Center International University of Health and Welfare, Mita Hospital Tokyo Japan
9. Department of Hepato‐Biliary‐Pancreatic & Gastrointestinal Surgery International University of Health and Welfare School of Medicine Chiba Japan
10. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine Tokyo Medical and Dental University Tokyo Japan
Abstract
AbstractBackgroundAlthough adjuvant gemcitabine (GEM) monotherapy improves the overall survival (OS) of patients with resected pancreatic cancer, its efficacy requires further improvement. This multicenter, phase II study investigated the efficacy of adjuvant portal vein infusion (PVI) chemotherapy followed by GEM therapy in patients with resected pancreatic cancer.Methods5‐fluorouracil (250 mg/day) and heparin (2000 IU/day) PVI chemotherapy were combined with systemic administration of mitomycin C (4 mg; days 6, 13, 20, and 27) and cisplatin (10 mg; days 7, 14, 21, and 28) for 4 weeks (PI4W), followed by GEM (1000 mg/m2; days 1, 8, and 15 every 4 weeks for 6 months). The primary endpoint was relapse‐free survival (RFS) and the secondary endpoints were OS and treatment completion.ResultsBetween November 2010 and August 2013, 53 patients who underwent complete resection were enrolled, including 30, 20, and 3 patients who underwent pancreaticoduodenectomies and distal and total pancreatectomies, respectively. In total, 51 (96.2%) patients underwent R0 resection, of whom 3, 2, 12, 35, 0, and 1 had stages IA, IB, IIA, IIB, III, and IV cancer, respectively, and 47 (88.7%) patients completed PI4W. The median RFS was 22.0 months (1‐, 3‐, 5, and 10 years RFS: 64.9%, 38.1%, 38.1%, and 38.1%, respectively), whereas the median OS was 32.0 months (1‐, 3‐, 5, and 10 years OS:86.6%, 47.2%, 44.4%, and 44.4%, respectively).ConclusionTreatment with PI4W followed by GEM for 6 months after surgery may be beneficial in patients undergoing curative resection of pancreatic cancer.