Pancreaticoduodenectomy for pancreatic adenocarcinoma: Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience

Charles J. Yeo, Ross A. Abrams, Louise B. Grochow, Taylor A. Sohn, Sarah E. Ord, Ralph H Hruban, Marianna L. Zahurak, William C. Dooley, JoAnn Coleman, Patricia K. Sauter, Henry A. Pitt, Keith D. Lilltemoe, John L Cameron

Research output: Contribution to journalArticle

Abstract

Objective: This study was designed to evaluate prospectively survival after pancreaticoduodenectomy for pancreatic adenocarcinoma, comparing two different postoperative adjuvant chemoradiation protocols to those of no adjuvant therapy. Summary Background Data: Based on limited data from the Gastrointestinal Tumor Study Group, adjuvant chemoradiation therapy has been recommended after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. However, many patients continue to receive no such therapy. Methods: From October 1991 through September 1995, all patients with resected, pathologically confirmed adenocarcinoma of the head, neck, or uncinate process of the pancreas were reviewed by a multidisciplinary group (surgery, radiation oncology, medical oncology, and pathology) and were offered three options for postoperative treatment after pancreaticoduodenectomy: 1) standard therapy: external beam radiation therapy to the pancreatic bed (4000-4500 cGy) given with two 3-day fluorouracil (5- FU) courses and followed by weekly bolus 5-FU (500 mg/m2 per day) for 4 months; 2) intensive therapy: external beam radiation therapy to the pancreatic bed (5040-5760 cGy) with prophylactic hepatic irradiation (2340- 2700 cGy) given with and followed by infusional 5-FU (200 mg/m2 per day) plus leucovorin (5 mg/m2 per day) for 5 of 7 days for 4 months; or 3) no therapy: no postoperative radiation therapy or chemotherapy. Results: Pancreaticoduodenectomy was performed in 174 patients, with 1 in-hospital death (0.6%). Ninety-nine patients elected standard therapy, 21 elected intensive therapy, and 53 patients declined therapy. The three groups were comparable with respect to race, gender, intraoperative blood loss, tumor differentiation, lymph node status, tumor diameter, and resection margin status. Univariate analyses indicated that tumor diameter

Original languageEnglish (US)
Pages (from-to)621-636
Number of pages16
JournalAnnals of Surgery
Volume225
Issue number5
DOIs
StatePublished - 1997

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Pancreaticoduodenectomy
Adenocarcinoma
Survival
Fluorouracil
Therapeutics
Radiotherapy
Pancreas
Neoplasms
Neck
Head
Radiation Oncology
Medical Oncology
Leucovorin
Lymph Nodes
Pathology
Drug Therapy

ASJC Scopus subject areas

  • Surgery

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Pancreaticoduodenectomy for pancreatic adenocarcinoma : Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience. / Yeo, Charles J.; Abrams, Ross A.; Grochow, Louise B.; Sohn, Taylor A.; Ord, Sarah E.; Hruban, Ralph H; Zahurak, Marianna L.; Dooley, William C.; Coleman, JoAnn; Sauter, Patricia K.; Pitt, Henry A.; Lilltemoe, Keith D.; Cameron, John L.

In: Annals of Surgery, Vol. 225, No. 5, 1997, p. 621-636.

Research output: Contribution to journalArticle

Yeo, CJ, Abrams, RA, Grochow, LB, Sohn, TA, Ord, SE, Hruban, RH, Zahurak, ML, Dooley, WC, Coleman, J, Sauter, PK, Pitt, HA, Lilltemoe, KD & Cameron, JL 1997, 'Pancreaticoduodenectomy for pancreatic adenocarcinoma: Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience', Annals of Surgery, vol. 225, no. 5, pp. 621-636. https://doi.org/10.1097/00000658-199705000-00018
Yeo, Charles J. ; Abrams, Ross A. ; Grochow, Louise B. ; Sohn, Taylor A. ; Ord, Sarah E. ; Hruban, Ralph H ; Zahurak, Marianna L. ; Dooley, William C. ; Coleman, JoAnn ; Sauter, Patricia K. ; Pitt, Henry A. ; Lilltemoe, Keith D. ; Cameron, John L. / Pancreaticoduodenectomy for pancreatic adenocarcinoma : Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience. In: Annals of Surgery. 1997 ; Vol. 225, No. 5. pp. 621-636.
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title = "Pancreaticoduodenectomy for pancreatic adenocarcinoma: Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience",
abstract = "Objective: This study was designed to evaluate prospectively survival after pancreaticoduodenectomy for pancreatic adenocarcinoma, comparing two different postoperative adjuvant chemoradiation protocols to those of no adjuvant therapy. Summary Background Data: Based on limited data from the Gastrointestinal Tumor Study Group, adjuvant chemoradiation therapy has been recommended after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. However, many patients continue to receive no such therapy. Methods: From October 1991 through September 1995, all patients with resected, pathologically confirmed adenocarcinoma of the head, neck, or uncinate process of the pancreas were reviewed by a multidisciplinary group (surgery, radiation oncology, medical oncology, and pathology) and were offered three options for postoperative treatment after pancreaticoduodenectomy: 1) standard therapy: external beam radiation therapy to the pancreatic bed (4000-4500 cGy) given with two 3-day fluorouracil (5- FU) courses and followed by weekly bolus 5-FU (500 mg/m2 per day) for 4 months; 2) intensive therapy: external beam radiation therapy to the pancreatic bed (5040-5760 cGy) with prophylactic hepatic irradiation (2340- 2700 cGy) given with and followed by infusional 5-FU (200 mg/m2 per day) plus leucovorin (5 mg/m2 per day) for 5 of 7 days for 4 months; or 3) no therapy: no postoperative radiation therapy or chemotherapy. Results: Pancreaticoduodenectomy was performed in 174 patients, with 1 in-hospital death (0.6{\%}). Ninety-nine patients elected standard therapy, 21 elected intensive therapy, and 53 patients declined therapy. The three groups were comparable with respect to race, gender, intraoperative blood loss, tumor differentiation, lymph node status, tumor diameter, and resection margin status. Univariate analyses indicated that tumor diameter",
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T1 - Pancreaticoduodenectomy for pancreatic adenocarcinoma

T2 - Postoperative adjuvant chemoradiation improves survival: A prospective, single-institution experience

AU - Yeo, Charles J.

AU - Abrams, Ross A.

AU - Grochow, Louise B.

AU - Sohn, Taylor A.

AU - Ord, Sarah E.

AU - Hruban, Ralph H

AU - Zahurak, Marianna L.

AU - Dooley, William C.

AU - Coleman, JoAnn

AU - Sauter, Patricia K.

AU - Pitt, Henry A.

AU - Lilltemoe, Keith D.

AU - Cameron, John L

PY - 1997

Y1 - 1997

N2 - Objective: This study was designed to evaluate prospectively survival after pancreaticoduodenectomy for pancreatic adenocarcinoma, comparing two different postoperative adjuvant chemoradiation protocols to those of no adjuvant therapy. Summary Background Data: Based on limited data from the Gastrointestinal Tumor Study Group, adjuvant chemoradiation therapy has been recommended after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. However, many patients continue to receive no such therapy. Methods: From October 1991 through September 1995, all patients with resected, pathologically confirmed adenocarcinoma of the head, neck, or uncinate process of the pancreas were reviewed by a multidisciplinary group (surgery, radiation oncology, medical oncology, and pathology) and were offered three options for postoperative treatment after pancreaticoduodenectomy: 1) standard therapy: external beam radiation therapy to the pancreatic bed (4000-4500 cGy) given with two 3-day fluorouracil (5- FU) courses and followed by weekly bolus 5-FU (500 mg/m2 per day) for 4 months; 2) intensive therapy: external beam radiation therapy to the pancreatic bed (5040-5760 cGy) with prophylactic hepatic irradiation (2340- 2700 cGy) given with and followed by infusional 5-FU (200 mg/m2 per day) plus leucovorin (5 mg/m2 per day) for 5 of 7 days for 4 months; or 3) no therapy: no postoperative radiation therapy or chemotherapy. Results: Pancreaticoduodenectomy was performed in 174 patients, with 1 in-hospital death (0.6%). Ninety-nine patients elected standard therapy, 21 elected intensive therapy, and 53 patients declined therapy. The three groups were comparable with respect to race, gender, intraoperative blood loss, tumor differentiation, lymph node status, tumor diameter, and resection margin status. Univariate analyses indicated that tumor diameter

AB - Objective: This study was designed to evaluate prospectively survival after pancreaticoduodenectomy for pancreatic adenocarcinoma, comparing two different postoperative adjuvant chemoradiation protocols to those of no adjuvant therapy. Summary Background Data: Based on limited data from the Gastrointestinal Tumor Study Group, adjuvant chemoradiation therapy has been recommended after pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas. However, many patients continue to receive no such therapy. Methods: From October 1991 through September 1995, all patients with resected, pathologically confirmed adenocarcinoma of the head, neck, or uncinate process of the pancreas were reviewed by a multidisciplinary group (surgery, radiation oncology, medical oncology, and pathology) and were offered three options for postoperative treatment after pancreaticoduodenectomy: 1) standard therapy: external beam radiation therapy to the pancreatic bed (4000-4500 cGy) given with two 3-day fluorouracil (5- FU) courses and followed by weekly bolus 5-FU (500 mg/m2 per day) for 4 months; 2) intensive therapy: external beam radiation therapy to the pancreatic bed (5040-5760 cGy) with prophylactic hepatic irradiation (2340- 2700 cGy) given with and followed by infusional 5-FU (200 mg/m2 per day) plus leucovorin (5 mg/m2 per day) for 5 of 7 days for 4 months; or 3) no therapy: no postoperative radiation therapy or chemotherapy. Results: Pancreaticoduodenectomy was performed in 174 patients, with 1 in-hospital death (0.6%). Ninety-nine patients elected standard therapy, 21 elected intensive therapy, and 53 patients declined therapy. The three groups were comparable with respect to race, gender, intraoperative blood loss, tumor differentiation, lymph node status, tumor diameter, and resection margin status. Univariate analyses indicated that tumor diameter

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