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[Correspondence] Improving post-surgical management of resected pancreatic cancer

We read with interest the results of the ESPAC-4 trial and congratulate John Neoptolemos and colleagues (March 11, p 1011)1 on having done this challenging investigation. On the basis of overall survival, the primary study endpoint, ESPAC-4 was a positive trial favouring the gemcitabine plus capecitabine group more than the gemcitabine monotherapy group (hazard ratio [HR] 0·82, 95% CI 0·68–0·98; p=0·032). However, in contrast to other previous randomised trials in the adjuvant setting, the secondary endpoint—ie, relapse-free survival—was not different between the two comparator groups (HR 0·86, 0·73–1·02; p=0·082).