Long-term results of adjuvant gemcitabine plus S-1 chemotherapy after surgical resection for pancreatic carcinoma

J Surg Oncol. 2012 Aug 1;106(2):174-80. doi: 10.1002/jso.23068. Epub 2012 Feb 13.

Abstract

Background and objectives: This study evaluated long-term outcomes for patients who received adjuvant gemcitabine plus S-1 chemotherapy after resection for pancreatic carcinoma.

Methods: Seventy patients who underwent surgical resection of pancreatic carcinoma were enrolled prospectively into this study. All patients received adjuvant chemotherapy with 10 cycles of gemcitabine plus S-1 every 2 weeks. Each cycle consisted of intravenous gemcitabine 700 mg/m(2) on day 1 and oral S-1 50 mg/m(2) for seven consecutive days, followed by a 1-week pause of chemotherapy. Long-term survival results of adjuvant gemcitabine plus S-1 chemotherapy were analyzed for this cohort.

Results: Median follow-up time was 51.2 months. Sixty percent of patients had node-positive disease and 79% of patients underwent R0 resection. Fifty-six patients (80%) completed adjuvant chemotherapy. Median overall and disease-free survival times were 35.4 and 23.8 months, respectively. Actuarial overall and disease-free survival rates were 89% and 64% at 1 year, 64% and 50% at 2 years, and 33% and 33% at 5 years, respectively. Only negative lymph node metastasis (P = 0.010) independently correlated with long-term survival by multivariate analysis.

Conclusions: Long-term results of adjuvant gemcitabine plus S-1 chemotherapy suggest this regimen may be safe and promising as treatment for this patient population.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma / drug therapy*
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / surgery
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Disease-Free Survival
  • Drug Combinations
  • Female
  • Gemcitabine
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oxonic Acid / administration & dosage
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Prospective Studies
  • Tegafur / administration & dosage
  • Time Factors
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Drug Combinations
  • Deoxycytidine
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • Gemcitabine