ABSTRACT
Pancreatic cancer currently represents the fourth leading cause of cancer-related mortality in the United States, with most recent cancer statistics indicating that an estimated 31,800 individuals will die of this disease in 2005 (1). Five-year survival rate for all stages combined is approximately 3% to 4%––the lowest of any cancer site (1). Approximately 15% of all patients have operable disease at the time of diagnosis. However, despite improvements in staging evaluation, surgical techniques, and immediate postoperative care, with accumulating evidence that perioperative mortality can be reduced if pancreatic cancer operations are performed at highvolume centers, the five-year survival rate in patients undergoing a potentially “curative” resection remains only 15% to 20% (1,2). These modest outcomes are a direct reflection of the high rates of both local and distant recurrence that occur in these patients, with the vast majority of relapses occurring within 24 months of the time of surgery (3). This chapter will address the mounting evidence to support the role for adjuvant therapy, in particular, chemotherapy, in decreasing the likelihood of recurrence and improving survival rates.
