Survival and prognostic factors of unresectable pancreatic cancer.
- Author:
Joo Kyung PARK
1
;
Yong Bum YOON
;
Yong Tae KIM
;
Ji Kon RYU
;
Jun Kyu LEE
;
Won Jae YOON
;
Sang Hyub LEE
Author Information
1. Department of Internal Medicine, College of Medicine Seoul National University, Seoul, Korea. yyb10604@plaza,snu.ac.kr
- Publication Type:Original Article
- Keywords:
Pancreatic cancer;
CA 19-9;
Staging;
Chemotherapy;
Radiotherapy
- MeSH:
Chemoradiotherapy;
Drug Therapy;
Humans;
Medical Records;
Middle Aged;
Multivariate Analysis;
Neoplasm Staging;
Pancreatic Neoplasms*;
Prognosis;
Radiotherapy;
Retrospective Studies
- From:Korean Journal of Medicine
2007;72(2):151-161
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The prognosis of pancreatic cancer is very poor and it is generally unresectable when it is diagnosed. The aim of this study is to evaluate the prognostic significance of the clinical and laboratory variables, and the survival for unresectable pancreatic cancer patients. METHODS: We retrospectively collected 245 unresectable pancreatic cancer patients who were diagnosed and had their disease pathologically proved between Jan. 1999 to Dec. 2004. They underwent palliative interventions, including surgical bypass, palliative chemotherapy, palliative radiotherapy or supportive care. We also reviewed the medical records for the clinical and laboratory variables, and we investigated their survival data. RESULTS: The mean age of the patients was 60 years old (range: 28-87) and the median overall survival was 5.5 months. Age, performance status, tumor location, initial CA 19-9 level, AJCC staging and the treatment modality had prognostic significance on univariate analysis. On multivariate analysis, performance status, tumor location, AJCC staging and the treatment modality were independent prognostic factors. On the subgroup analysis, stage III patients who underwent concurrent chemoradiotherapy (CCRT, median OS 10.6 months) or chemotherapy alone (12.7) showed survival benefit over the best supportive care (6.1). Stage IV patients who underwent chemotherapy (6.3) alone showed survival benefit over the best supportive care (3.4). CONCLUSIONS: The performance status, AJCC staging, tumor location and the treatment modality were independent prognostic factors of unresectable pancreatic cancer. The patients who received chemotherapy or CCRT showed better survival than those who received the best supportive care group. Therefore, active treatment modality should be considered for unresectable pancreatic cancer.
