[Clinical study of the month. Adjuvant radio-chemotherapy and chemotherapy following curative resection of pancreatic cancer: results of the randomized trial ESPAC-1]. / Etude clinique du mois. Radio-chimiothérapie et chimiothérapie adjuvante après résection à visée curative du cancer du pancréas: résultats de l'étude randomisée ESPAC-1.

The prognosis of pancreatic adenocarcinoma remains poor, with a 5-year survival rate lower than 5%. Resection, the gold standard treatment, can be performed in less than 15% of patients. Following surgery, the median survival is 12 months for the most favourable cancer patients. Adjuvant treatment have attempted to improve results. However, chemotherapy, radiotherapy and multimodal treatments don't have demonstrated a clear advantage in controlled trials. We will discuss results of the current trials in this topic. The randomised trial of the European Study Group for Pancreatic Cancer (ESPAC) recently published in the Lancet revealed a potential benefit of adjuvant chemotherapy. A critical analysis of the publication showed, however, that definitive conclusions of this trial must be interpreted with caution.