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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 578-589 |
| Number of pages | 12 |
| Journal | International Journal of Clinical Practice |
| Volume | 68 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 2014 |
| Externally published | Yes |
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- Medicine(all)
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Survival outcomes in patients with early stage, resected pancreatic cancer - A comparison of gemcitabine- and 5-fluorouracil-based chemotherapy and chemoradiation regimens. / Kizilbash, Sani; Ward, K. C.; Liang, J. J.; Jaiyesimi, I.; Lipscomb, J.
In: International Journal of Clinical Practice, Vol. 68, No. 5, 01.01.2014, p. 578-589.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival outcomes in patients with early stage, resected pancreatic cancer - A comparison of gemcitabine- and 5-fluorouracil-based chemotherapy and chemoradiation regimens
AU - Kizilbash, Sani
AU - Ward, K. C.
AU - Liang, J. J.
AU - Jaiyesimi, I.
AU - Lipscomb, J.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84899419316&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899419316&partnerID=8YFLogxK
U2 - 10.1111/ijcp.12353
DO - 10.1111/ijcp.12353
M3 - Article
C2 - 24472057
AN - SCOPUS:84899419316
VL - 68
SP - 578
EP - 589
JO - International Journal of Clinical Practice
JF - International Journal of Clinical Practice
SN - 1368-5031
IS - 5
ER -