Postoperative chemotherapy more than doubles survival rates for patients with pancreatic cancer, according to an article in the March 18th issue of the New England Journal of Medicine. The final results come from the European Study Group for Pancreatic Cancer 1 Trial of more than 280 patients, which compared surgery alone with surgery and chemotherapy (5-fluorouracil) or surgery and chemoradiotherapy.

Current survival rates for patients with pancreatic cancer are disappointingly low, with only 2 to 3 percent of patients alive at 5 years. However, in the current trial, the largest to date, investigators found that the difference with chemotherapy versus no chemotherapy was dramatic: The 5-year survival rate was 21 percent for patients who received chemotherapy and 8 percent for patients who did not receive chemotherapy. The benefit persisted after adjustment for major prognostic factors.

In contrast, not only did chemoradiotherapy not confer survival benefit, the investigators concluded it had a deleterious effect: Five-year survival was estimated at 10 percent for patients who had chemoradiotherapy and 20 percent among patients who did not receive chemoradiotherapy.

The authors conclude that all patients who have operable cancer should be considered for chemotherapy. Professor Philip Johnson, a British investigator involved with the study, said "The common belief among doctors is that the disease is untreatable and this has become a self-fulfilling prophesy. Now we can say unequivocally that treating patients with standard chemotherapy does offer precious extra months of life."

He added, "We're still a long way from curing pancreatic cancer but this research represents a vital first step. Now we can build on this success by investigating other, newer drugs and combinations of drugs."

Professor Robert Souhami, another British researcher, said "Pancreatic cancer causes thousands of deaths each year but, until now, the role of chemotherapy and radiation in treatment has not been clear. This research shows improved survival with chemotherapy and offers hope that new drug treatments will lead to further advances."