Adjuvant therapies in extended pancreatectomy for ductal adenocarcinoma of the pancreas.

Background/aims: The poor prognosis after pancreatic cancer resection is attributed to a high incidence of locoregional recurrence and hepatic metastasis. The present study was carried out in order to determine whether adjuvant therapies improve patient survival.
Methodology: Preoperative irradiation and postoperative liver perfusion chemotherapy have been added to the extended pancreatectomy procedure, and a retrospective analysis of 111 patients was performed.
Results: Preoperative irradiation (n = 17) significantly decreased the incidence of locoregional recurrence but increased the incidence of hepatic metastasis, with no improvement in the 5-year survival rate (from 27% to 23%). In contrast, postoperative liver perfusion chemotherapy (n = 27) succeeded in improving the 5-year survival rate to 39% by significantly decreasing the incidence of hepatic metastasis.
Conclusion: These data suggest that the patients' survival rate may be increased when these two types of adjuvant therapy are combined with extended pancreatectomy.