Clinical Study

BJC Open article

British Journal of Cancer (2009) 100, 246–250. doi:10.1038/sj.bjc.6604838 www.bjcancer.com
Published online 6 January 2009

Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the ESPAC-1 and -3(v1) trials

J P Neoptolemos1, D D Stocken2, C Tudur Smith1, C Bassi3, P Ghaneh4, E Owen1, M Moore5, R Padbury6, R Doi7, D Smith8 and M W Büchler9 for the European Study Group of Pancreatic Cancer

  1. 1CR-UK Liverpool Cancer Trials Unit, University of Liverpool Cancer Research Centre, 200 London Road, Liverpool L3 9TA, UK
  2. 2Cancer Research UK Clinical Trials Unit, Institute for Cancer Studies, 3rd floor Clinical Research Block, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
  3. 3Surgical and Gastroenterological department, Verona University, Piazzale LA Scuro, 10 37134 Verona, Italy
  4. 4Division of Surgery and Oncology, School of Cancer Studies, University of Liverpool, 5th Floor UCD Building, Daulby Street, Liverpool L69 3GA, UK
  5. 5Rm 5-708, Princess Margaret Hospital, 610 University Avenue, Toronto M5G2M9, Canada
  6. 6Flinders Medical Centre, Flinders Drive, Bedford Park, 5042 South Australia, Australia
  7. 7Department of Surgery, Kyoto University, 54 Shogoinkawaracho, Sakyo, Kyoto 606-8507, Japan
  8. 8Medical Oncology, Clatterbridge Centre for Oncology, Clatterbridge Road, Bebington, Merseyside CH63 4JY, UK
  9. 9Department of General Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-6910 Heidelberg, Germany

Correspondence: Professor JP Neoptolemos, E-mail: j.p.neoptolemos@liverpool.ac.uk

Revised 21 November 2008; Accepted 25 November 2008; Published online 6 January 2009.

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Abstract

The ESPAC-1, ESPAC-1 plus, and early ESPAC-3(v1) results (458 randomized patients; 364 deaths) were used to estimate the effectiveness of adjuvant 5FU/FA vs resection alone for pancreatic cancer using meta-analysis. The pooled hazard ratio of 0.70 (95% CI=0.55–0.88) P=0.003, and the median survival of 23.2 (95% CI=20.1–26.5) months with 5FU/FA vs 16.8 (95% CI=14.3–19.2) months with resection alone supports the use of adjuvant 5FU/FA in pancreatic cancer.

Keywords:

pancreatic cancer, gemcitabine, 5-flurouracil, chemoradiation, randomized trial