694pimpact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma

ABSTRACT Aim: We examined impact of adjuvant treatment modalities in patients with curatively resected pancreatric adenocarcinoma (PAC). Methods: A total of 563 consecutive patients who were resected for PAC in 26 oncology centers were retrospectively analyzed between January 2003 and December 2013. Results: Of 563 patients, 472 received adjuvant treatment with chemotherapy alone (CT), chemoradiotherapy alone (CRT), and chemoradiotherapy with maintenance chemotherapy (CRT-CT) were analyzed. Of 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. Survival rates at 1st, 3rd, and 5th years were 70%, 23% and 16%, respectively. When CT and CRT-CT groups were compared, there was no difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT alone groups. To further investigate the impact of addition of radiation to chemotherapy on subgroups, patients were stratified according to lymph node status and resection margins, and then analyzed separately. When patients with positive lymph node disease were considered, both RFS (p = 0.004) and OS (p = 0.003) were significantly longer in CRT-CT group than CT group. In contrast, there was no difference between groups when patients with no metastatic lymph node disease or patients with or without positive surgical margins were considered. Conclusions: Although adjuvant chemotherapy is the standart treatment in curatively resected PAC, radiation should be a part of treatment at least in patients with positive lymph node disease. Disclosure: All authors have declared no conflicts of interest.