XXXX . Postoperative radiotherapy does not improve survival.

@entity1 @entity137 @entity5 @entity201 @entity3
OBJECTIVE: The aims of this analysis were to determine prospectively the effects of surgical resection and radiation therapy on the length and quality of survival as well as late @entity137 in @entity1 with @entity201 . BACKGROUND: Retrospective analyses have suggested that adjuvant radiation therapy improves survival in @entity1 with @entity201 . However, in these reports, @entity1 receiving radiotherapy tended to have smaller, often resectable @entity5 , and were relatively fit. In comparison, @entity1 who have not received radiotherapy often had unresectable @entity5 , @entity3 , or poor performance status. METHODS: From 1988 through 1993, surgically staged @entity1 with @entity201 and 1) no evidence of @entity3 , 2) Karnofsky score > 60, 3) no prior @entity5 or radiotherapy, and 4) a patent main portal vein were analyzed. Fifty @entity1 were stratified by resection (n = 31) versus operative palliation (n = 19) and by radiation (n = 23) versus no radiotherapy (n = 27). RESULTS: @entity1 undergoing resection had smaller @entity5 (1.9 +/- 2.8 vs. 2.4 +/- 2.1 cm, p < 0.01) that were less likely to invade the hepatic artery (3% vs. 42%, p < 0.05) or portal vein (6% vs. 53%, p < 0.05). Multiple parameters that might have affected outcome were similar between @entity1 who did and did not receive radiation therapy. Resection improved the length (24.2 +/- 2.5 vs. 11.3 +/- 1.0 months, p < 0.05) and quality of survival. Radiation had no effect on the length (18.4 +/- 2.9 vs. 20.1 +/- 2.4 months) or quality of survival or on late @entity137 . CONCLUSIONS: This analysis suggests that in @entity1 with localized @entity201 , resection prolongs survival whereas radiation has no effect on either survival or late @entity137 . Thus, new agents or strategies to deliver adjuvant therapy are needed to improve survival in these @entity1 .
