Survival effects of adjuvant gemcitabine plus S-1 chemotherapy on pancreatic carcinoma stratified by preoperative resectablity status

Background and Objectives

The aim of this study was to evaluate the efficacy of adjuvant gemcitabine plus S-1(GS) chemotherapy for pancreatic carcinoma patients, stratified by the National Comprehensive Cancer Network (NCCN) preoperative resectability definition.

Methods

A total of 141 consecutive patients with resected pancreatic carcinoma who received adjuvant GS chemotherapy were evaluated retrospectively. According to the NCCN preoperative resectability definition, tumors were divided into resectable tumors (R group), borderline resectable tumors with portal vein contact (BR-PV group), and borderline resectable tumors with arterial contact (BR-A group). Overall survival and prognostic factors were analyzed.

Results

Overall 1-, 2-, and 5-year survival rates for the 141 patients were 89.6%, 69.9%, and 41.1%, respectively. Overall survival of the R group was significantly better than that of the BR-PV group and the BR-A group (P < 0.05). Overall 5-year survival rates of the R group, the BR-PV group, and the BR-A group were 49.0%, 25.0%, and 11.3%, respectively. Arterial contact (P = 0.020), preoperative CA 19-9 level ≥150 U/ml (P < 0.001), and positive nodal involvement (P = 0.025) were independent prognostic factors for poor overall survival.

Conclusions

Adjuvant GS chemotherapy may provide a survival benefit especially for patients with resectable pancreatic carcinoma. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.

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