Preoperative versus postoperative adjuvant therapy for adenocarcinoma of the pancreas

Because there have been no RCTs of preoperative and postoperative AT sequencing in the treatment of resectable and borderline resectable pancreatic cancer, it is impossible to assess their relative values with confidence. Three nonrandomized experiences of both treatment approaches from single institutions provide some assurance that preoperative AT is not inferior to postoperative AT. Phase II trials for both resectable and borderline resectable tumors suggest that longer median survival can be obtained by a policy of preoperative AT. We will watch the European RCT with great interest.