Gemcitabine in patients with intraductal papillary mucinous neoplasm with an associated invasive carcinoma of the pancreas

Pancreas. 2013 Jul;42(5):889-92. doi: 10.1097/MPA.0b013e3182826f1f.

Abstract

Objectives: The standard chemotherapy for invasive ductal carcinoma of the pancreas (IDC) is gemcitabine; however, the efficacy of gemcitabine in invasive intraductal papillary mucinous neoplasm with an associated invasive carcinoma of the pancreas (IPMN-IC) is still unknown.

Methods: Because it is difficult to distinguish between IPMN-IC and IDC based only on radiological findings in advanced unresectable cases, recurrent cases after surgical resection were analyzed to identify the efficacy of gemcitabine monotherapy for IPMN-IC.

Results: Between 1992 and 2010, 128 patients with IPMN-IC and 548 patients with IDC underwent pancreatic resection at the National Cancer Center Hospital. Twelve patients with IPMN-IC and 73 patients with IDC had recurred after surgery and subsequently underwent gemcitabine at the standard dosage. The disease-control rates were comparable between the IPMN-IC and IDC patients (58.3% vs 59.4%). The median progression-free survival was 2.8 and 4.1 months in the IPMN-IC and IDC patients, respectively (P = 0.46). Also, no statistically significant difference in the median survival times was observed between the 2 groups (9.3 vs 8.8 months, respectively; P = 0.09).

Conclusions: Among patients who had IPMN-IC and IDC with recurrent disease after resection, there was no significant difference in treatment outcomes after gemcitabine.

MeSH terms

  • Adenocarcinoma, Mucinous / drug therapy*
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / therapeutic use
  • Carcinoma, Pancreatic Ductal / drug therapy*
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Papillary / drug therapy*
  • Carcinoma, Papillary / surgery
  • Chi-Square Distribution
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Disease-Free Survival
  • Female
  • Gemcitabine
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / surgery
  • Time Factors
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Gemcitabine