Covered self-expandable metallic stent versus plastic stent for preoperative endoscopic biliary drainage in patients with pancreatic cancer: a multi-center retrospective cohort study

Abstract Background Perioperative anesthetic management may affect long-term outcome after cancer surgery. This study aimed to investigate the effect of perioperative glucocorticoids on long-term survival in patients after radical resection for pancreatic cancer.Methods In this retrospective cohort study, patients who underwent radical resection for pancreatic cancer from January 2005 to December 2016 were recruited. Baseline and perioperative data including use of glucocorticoids for prevention of postoperative nausea and vomiting were collected. Patients were followed up for tumor recurrence and survival. The primary outcome was the overall survival (OS); the secondary outcome was the recurrence-free survival (RFS). A multivariable Cox proportional hazard model was used to analyze the influence of perioperative glucocorticoid use on OS and RFS after correction for confounding factors.Results A total of 215 patients after radical surgery for pancreatic cancer were included in the study; of these, 112 received perioperative glucocorticoids and 103 did not. Patients were followed up for a median of 74.0 months (95% confidence interval [CI] 68.3-79.7). Both OS and RFS were significantly longer in patients with glucocorticoids than in those without (for OS: median 19.7 months [95% CI 12.3-36.2] vs. 13.9 months [8.0-23.9], P=0.001; for RFS: 12.0 months [6.0-28.0] vs. 6.9 months [4.2-17.0], P=0.002). After correction for confounding factors, perioperative glucocorticoids were significantly associated with prolonged OS (HR 0.692, 95% CI 0.499-0.959, P=0.027) and RFS (HR 0.634, 95% CI 0.459-0.878, P=0.006).Conclusions Perioperative use of low-dose glucocorticoids may improve long-term survival in patients undergoing radical surgery for pancreatic cancer.

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Use of chemotherapy and radiotherapy in patients with pancreatic cancer in Victoria (2002–2003): a retrospective cohort study

The Medical Journal of Australia ◽

10.5694/j.1326-5377.2010.tb03531.x ◽

2010 ◽

Vol 192 (6) ◽

pp. 323-327 ◽

Cited By ~ 6

Author(s):

Michael Jefford ◽

Vicky Thursfield ◽

Yvonne Torn‐Broers ◽

Trevor Leong ◽

Mario Guerrieri ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

PeerJ ◽

10.7717/peerj.4893 ◽

2018 ◽

Vol 6 ◽

pp. e4893 ◽

Cited By ~ 6

Author(s):

Shuisheng Zhang ◽

Xiaozhun Huang ◽

Yuan Tian ◽

Saderbieke Aimaiti ◽

Jianwei Zhang ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Lymph Node ◽

Distant Metastasis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinicopathologic Characteristics ◽

Treatment Protocols ◽

Laboratory Parameters

Objectives The prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer. Methods Patients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Results The present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82). Conclusions Being male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.

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