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Author Notes:

Sani Haider Kizilbash, MBBS, MPH. Division of Hematology/Oncology, Mayo Clinic. 200 First St SW, Rochester, MN 55905. kizilbash.sani@mayo.edu Ph: (507) 2842511; Fax (507) 2841803.

Drs. Kizilbash, Ward, Jaiyesimi, and Lipscomb were involved in the conception/design and data analysis of this study in addition to the critical revision of the article; Dr. Liang was involved in the interpretation of the data and critical revision of the article; All authors approve of the article.

We acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the SEER Program tumor registries in the creation of the SEER-Medicare database.

Authors reported no disclosures.

Subjects:

Research Funding:

This work was supported by the Metropolitan Atlanta SEER Registry under National Cancer Institute (NCI) contract N01-PC-35135 with Emory University.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, General & Internal
  • Pharmacology & Pharmacy
  • General & Internal Medicine
  • RANDOMIZED CONTROLLED-TRIAL
  • PHASE-III TRIAL
  • CURATIVE RESECTION
  • ADJUVANT CHEMOTHERAPY
  • PERIAMPULLARY REGION
  • COMORBIDITY INDEX
  • COOPERATIVE GROUP
  • FOLINIC ACID
  • CHEMORADIOTHERAPY
  • FLUOROURACIL

Survival outcomes in patients with early stage, resected pancreatic cancer-a comparison of gemcitabine-and 5-fluorouracil-based chemotherapy and chemoradiation regimens

Tools:

Journal Title:

International Journal of Clinical Practice

Volume:

Volume 68, Number 5

Publisher:

, Pages 578-589

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Purpose: We conducted a comparative survival analysis between patients with resected pancreatic cancer who received adjuvant treatment with either gemcitabine- or 5-fluorouracil-based chemotherapy and chemoradiation regimens. Patients and methods: The Surveillance, Epidemiology and End Results (SEER)-Medicare database was used to identify patients with pancreatic cancer diagnosed from 1998 to 2005 who received curative surgery and adjuvant chemotherapy with either 5-fluorouracil or gemcitabine. These groups were subdivided by treatment with radiotherapy. Patients were followed until death, study end-point or a maximum of 5 years after diagnosis. Results: Three hundred and fifty-nine patients received 5-fluorouracil and 346 received gemcitabine. Compared with chemoradiation with 5-fluorouracil, outcomes for patients who received chemoradiation with gemcitabine did not differ. Patients who received gemcitabine without radiation had increased hazards (poorly differentiated tumours: HR = 1.50, p = 0.01; moderately differentiated tumours, HR = 1.28, p = 0.11). However, outcomes of patients who received 5-fluorouracil without radiation varied with tumour grade. In moderately differentiated tumours, patients had better outcomes with 5-fluorouracil when compared with chemoradiation with 5-fluorouracil (HR = 0.42, p = 0.02). In poorly differentiated tumours, the opposite was true (HR 2.10, p = 0.09). Conclusion: Patients with low-grade resected pancreatic cancer may have better outcomes with 5-fluorouracil-based chemotherapy without radiation when compared with 5-fluorouracil with radiation.

Copyright information:

© 2014 John Wiley & Sons Ltd.

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