This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Related letters  • Similar articles in JAMA  Topic Collections  • Radiation Therapy  • Drug Therapy  • Drug Therapy, Other  • Gastroenterology  • Liver/ Biliary Tract/ Pancreatic Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their randomized controlled trial, Dr Regine and colleagues¹ compared the effects of gemcitabine and fluorouracil on survival after curative-intent resection of pancreatic adenocarcinoma followed by chemoradiation. The study found a survival benefit associated with the addition of gemcitabine, but this was not statistically significant. Of the patients, 66% had nodal metastases and 34% had microscopically positive margins, but lymph node examination rates and details about number of lymph nodes positive for metastatic cancer were not shown.

In a retrospective study including 905 patients who underwent pancreaticoduodenectomy for ductal cancer of the pancreas,² the total number of lymph node metastases or the ratio of the number of metastatic lymph nodes to the total number of lymph nodes examined was the strongest predictor of survival. In another study³ assessing the accuracy of staging node-negative pancreas cancer, which included 3505 patients who underwent pancreaticoduodenectomy for adenocarcinoma of the pancreas, . . . [Full Text of this Article]

Tetsuji Fujita, MD
tetsu@jg8.so-net.ne.jp
Jikei University of School of Medicine
Tokyo, Japan

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Fluorouracil vs Gemcitabine Chemotherapy Before and After Fluorouracil-Based Chemoradiation Following Resection of Pancreatic Adenocarcinoma: A Randomized Controlled Trial
William F. Regine, Kathryn A. Winter, Ross A. Abrams, Howard Safran, John P. Hoffman, Andre Konski, Al B. Benson, John S. Macdonald, Mahesh R. Kudrimoti, Mitchel L. Fromm, Michael G. Haddock, Paul Schaefer, Christopher G. Willett, and Tyvin A. Rich
JAMA. 2008;299(9):1019-1026.
ABSTRACT | FULL TEXT  

Adjuvant Chemotherapy With Gemcitabine vs Observation in Patients Undergoing Curative-Intent Resection of Pancreatic Cancer: A Randomized Controlled Trial
Helmut Oettle, Stefan Post, Peter Neuhaus, Klaus Gellert, Jan Langrehr, Karsten Ridwelski, Harald Schramm, Joerg Fahlke, Carl Zuelke, Christof Burkart, Klaus Gutberlet, Erika Kettner, Harald Schmalenberg, Karin Weigang-Koehler, Wolf-Otto Bechstein, Marco Niedergethmann, Ingo Schmidt-Wolf, Lars Roll, Bernd Doerken, and Hanno Riess
JAMA. 2007;297(3):267-277.
ABSTRACT | FULL TEXT  

RELATED LETTERS

Survival for Patients With Pancreatic Cancer After Addition of Gemcitabine to Fluorouracil Chemoradiation
Bhadrasain Vikram
JAMA. 2008;299(24):2852.
EXTRACT | FULL TEXT  

Survival for Patients With Pancreatic Cancer After Addition of Gemcitabine to Fluorouracil Chemoradiation—Reply
William F. Regine, Kathryn A. Winter, and Howard Safran
JAMA. 2008;299(24):2852-2853.
EXTRACT | FULL TEXT