Multiple Liver Metastases Rather Than the Presence of Liver Metastasis Is a Significantly Poor Prognostic Factor for Patients With Advanced Pancreatic Cancer

Pancreas ◽  
2020 ◽  
Vol 49 (7) ◽  
pp. e63-e65
Author(s):  
Kiyotsugu Iede ◽  
Terumasa Yamada ◽  
Ryo Kato ◽  
Masami Ueda ◽  
Yujiro Tsuda ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Prognostic Factor ◽  
Liver Metastases ◽  
Advanced Pancreatic Cancer ◽  
Poor Prognostic Factor ◽  
Multiple Liver Metastases

Clinical significance of serum alkaline phosphatase level in advanced pancreatic cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 183-183 ◽  
Author(s):  
I. Ohno ◽  
S. Mitsunaga ◽  
K. Nakachi ◽  
S. Shimizu ◽  
H. Takahashi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Prognostic Factor ◽  
Performance Status ◽  
Elevated Serum ◽  
Advanced Pancreatic Cancer ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Bile Stasis ◽  
Low Serum

183 Background: Alkaline phosphatase (ALP) is an enzyme that is elevated by various hepatobiliary diseases. Generally its elevation is thought to indicate bile stasis. There are some reports that show ALP is an important prognostic factor for several cancers such as colon, lung, and gastric cancer. Often it is speculated that ALP elevation indicates bile stasis caused by liver metastasis. However, the significance of ALP elevation in advanced pancreatic cancer (APC) patients is not well evaluated. The aim of this study was to determine the significance of elevated serum ALP as a prognostic factor in patients with APC even without jaundice and liver metastasis. Methods: Serum ALP levels were measured in 393 patients with APC receiving gemcitabine monotherapy before treatment, and according to those levels, patients were subgrouped (ALP<upper normal limit (UNL), UNL-500 U/L, 501-700 U/L, 701-1000 U/L, 1000U/L < ALP). The clinical data of each group were analyzed to see characteristics of elevated ALP patients. The relationship between ALP level and survival, response were also examined. Results: The elevated ALP group included poor performance status (PS>1) patients (41.3%, p=0.001), and associated with low serum albumin (3.31±0.38, p<0.01). The elevated ALP group (median survival time (MST) 112 days) showed significantly worse prognosis and lower disease control rate compared to the normal ALP group (MST 217days) (p<0.001, p<0.001). Multivariate analysis revealed ALP (p<0.001), CRP (p<0.001), ascites (p<0.001), distant metastasis (p=0.003), white blood cell count (p=0.005), PS (p=0.020), AST (p=0.020), and ALT (p=0.020) were independent prognostic factors. Similar results were seen in liver metastasis free patients without jaundice. Conclusions: Elevated serum ALP level correlated with poor performance status and low serum albumin. ALP was also the independent prognostic factor in liver metastasis free APC patients without jaundice. No significant financial relationships to disclose.

scholarly journals A case of long survival in advanced pancreatic cancer with multiple liver metastases successfully treated by combined chemotherapy of S-1 and gemcitabine

Suizo ◽  
2008 ◽  
Vol 23 (4) ◽  
pp. 510-518
Author(s):  
Shun-ichi ISHIGAMI ◽  
Nobuo BABA ◽  
Kazuhiko KITAGUCHI ◽  
Morito SAKIKUBO ◽  
Ryou KAMIMURA ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastases ◽  
Advanced Pancreatic Cancer ◽  
Combined Chemotherapy ◽  
Long Survival ◽  
Multiple Liver Metastases

Development and validation of a radiomics nomogram to discriminate advanced pancreatic cancer patients with liver metastases or other metastatic patterns.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 435-435
Author(s):  
Junjie Hang ◽  
Lixia Wu
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Validation Cohort ◽  
Advanced Pancreatic Cancer ◽  
Region Of Interest ◽  
Calibration Plot ◽  
Training Cohort ◽  
Kaplan Meier ◽  
Metastatic Patterns

435 Background: Pancreatic cancer patients with liver metastases had much poorer prognosis than those with other metastatic patterns. This study aimed to develop and validate a radiomics model to discriminate pancreatic cancer patients with liver metastases from patients with other metastatic patterns. Methods: We evaluated 77 patients advanced pancreatic cancer (APC) with different metastatic patterns and performed texture analysis on the region of interest (ROI). 58 patients and 19 patients were allocated randomly into the training cohort and the validation cohort with almost the same proportion of patients with liver metastases. An independent samples t-test was used for initial feature selection in the training cohort. Random Forest Classifier (RFC) was used to construct models based on these features in both cohorts and a radiomics signature (RS) was derived from the model. Then a nomogram was constructed based on RS and CA19-9, and validated with calibration plot and decision curve. The prognostic value of RS was evaluated by Kaplan-Meier methods. Results: A nomogram based on the RS and CA19-9 was constructed and it demonstrated good discrimination in the training cohort (AUC = 0.93) and validation cohort (AUC = 0.81). Kaplan-meier methods showed that patients with RS>0.61 had much poorer OS than patients with RS < 0.61 in both cohorts. Conclusions:This study presents a radiomics nomogram incorporating both RS and CA19-9, which can be used to discriminate advanced pancreatic cancer patients with liver metastases from patients with other metastatic patterns.

Maintenance of Skeletal Muscle Mass During FOLFIRINOX is a Favorable Prognostic Factor in Pancreatic Cancer Patients

2021 ◽  
Author(s):  
Dong Woo Shin ◽  
Minseok Albert Kim ◽  
Jong-chan Lee ◽  
Jaihwan Kim ◽  
Jin-Hyeok Hwang
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Clinical Outcomes ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Lumbar Vertebra ◽  
Resection Rate ◽  
Cross Sectional ◽  
Group 2

Abstract Objective: The study aimed to investigate the effect of body composition changes during chemotherapy on clinical outcomes in patients with pancreatic cancer.Results: In patients with locally advanced pancreatic cancer (LAPC), the cross-sectional area of skeletal muscle (SM) and adipose tissue (AT) at the level of third lumbar vertebra was measured. The SM and AT ratios indicated the changes during chemotherapy. The patients were classified into three groups based on these ratios: group 1, ≥1.00; group 2, 0.85-0.99; group 3, <0.85. The overall survival (OS) and surgical resection rates were estimated. Fifty-eight patients with LAPC who received first-line FOLFIRINOX were analysed. Fifteen (25.9%) patients who underwent resection showed maintained BMI, SM, and AT as compared to the patients who did not undergo resection. As the SM ratio decreased, the risk for death increased significantly. Further, the resection rate was significantly higher in patients with maintained SM compared to those with low SM ratio. On the contrary, the change in AT ratio was not associated with OS and resection rate; however, significant decrease in AT more than 15% showed poor clinical outcomes. Maintenance of SM during chemotherapy is a reliable prognostic factor indicating longer OS and higher resection rate.

scholarly journals Molecular Mechanism Underlying Lymphatic Metastasis in Pancreatic Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Zhiwen Xiao ◽  
Guopei Luo ◽  
Chen Liu ◽  
Chuntao Wu ◽  
Liang Liu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Adverse Event ◽  
High Risk ◽  
Prognostic Factor ◽  
Lymphatic Metastasis ◽  
Clinical Course ◽  
Cellular Mechanisms ◽  
Poor Prognostic Factor ◽  
Dismal Prognosis ◽  
Low Rate

As the most challenging human malignancies, pancreatic cancer is characterized by its insidious symptoms, low rate of surgical resection, high risk of local invasion, metastasis and recurrence, and overall dismal prognosis. Lymphatic metastasis, above all, is recognized as an early adverse event in progression of pancreatic cancer and has been described to be an independent poor prognostic factor. It should be noted that the occurrence of lymphatic metastasis is not a casual or stochastic but an ineluctable and designed event. Increasing evidences suggest that metastasis-initiating cells (MICs) and the microenvironments may act as a double-reed style in this crime. However, the exact mechanisms on how they function synergistically for this dismal clinical course remain largely elusive. Therefore, a better understanding of its molecular and cellular mechanisms involved in pancreatic lymphatic metastasis is urgently required. In this review, we will summarize the latest advances on lymphatic metastasis in pancreatic cancer.

Characterization of patients with high serum level of IL-6 in advanced pancreatic cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 197-197
Author(s):  
Tomofumi Miura ◽  
Shuichi Mitsunaga ◽  
Satoshi Shimizu ◽  
Izumi Ohno ◽  
Hideaki Takahashi ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Advanced Pancreatic Cancer ◽  
Disease Status ◽  
High Serum ◽  
Related Factor ◽  
Related Factors ◽  
Reactive Protein ◽  
Treatment Naïve

197 Background: IL-6 is a key mediator of cancer cachexia. The degree of cachexia affects serum IL-6 level in pancreatic cancer (PC) and is varied according to disease progression. The study population to characterize advanced PC patients with high IL-6 level needs the homogeneity in disease status. This study was aimed to identify IL-6-related factors in patients who were scheduled to undergo first-line chemotherapy for treatment-naïve advanced PC. Methods: Patients with treatment-naïve advanced PC were eligible for inclusion in this study. Patients with obvious infection or biliary drainage were excluded. Serum IL-6 levels and clinical parameters (e.g. symptoms, body composition) were prospectively collected. A high IL-6 level was defined as a value greater than the median value in all of the analyzed patients, and analyses were performed to identify risk factors for high IL-6 levels. Results: Eighty patients were analyzed. A multivariate analysis determined that the following parameters were associated with high IL-6: the presence of liver metastasis [Odds ratio (OR): 4.8, p < 0.01], fatigue (OR 3.4, p = 0.02), high carcinoembryonic antigen (CEA) levels (OR: 6.9, p = 0.03), anemia (OR: 9.5, p = 0.01), and high C-reactive protein (CRP) levels (OR: 12.4, p = 0.02). A decreased skeletal muscle mass tended to be frequently observed in patients with high IL-6 levels. Conclusions: High serum IL-6 related the presence of liver metastasis, severe fatigue, high CEA, high CRP and anaemia. Additionally, skeletal muscle loss might be the IL-6 related factor.

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