Shorter treatment-naïve leukocyte telomere length is associated with poorer overall survival of patients with pancreatic ductal adenocarcinoma

Abstract Purpose Cachexia influences the patient’s physical wellbeing and quality of life, and the patient’s ability to tolerate their cancer therapies, especially cytotoxic chemotherapy. The purpose of this study was to investigate the frequency and timing of onset of cancer cachexia during chemotherapy and its association with prognosis and toxicity in patients with pancreatic ductal adenocarcinoma (PDAC). Methods We performed a retrospective study in patients who underwent first-line chemotherapy after diagnosis of advanced PDAC between 6 June 2008 and 31 March 2017. Base cachexia (weight loss up to 6 months before starting first-line chemotherapy) and follow-up cachexia (after starting first-line chemotherapy) were defined as weight loss > 2% with a body mass index (BMI) < 20 kg/m2 or weight loss > 5%. Results A total of 150 patients were registered. The median age and BMI were 65 years and 21.7 kg/m2, respectively. Base cachexia occurred in 50% of patients. Follow-up cachexia occurred in 32% within 12 weeks of starting first-line chemotherapy, reaching 64% at 1 year. Overall survival was not significantly different between patients with and without follow-up cachexia, regardless of whether cancer cachexia occurred within 12, 24, or 48 weeks of starting first-line treatment. Appetite loss, fatigue, nausea, and diarrhea were more frequent in patients with follow-up cachexia than in those without follow-up cachexia. Conclusion Follow-up cachexia had an early onset, but was not a prognostic factor for overall survival in patients with PDAC. Some adverse events tended to be more frequent in patients with follow-up cachexia than in those without follow-up cachexia.

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CT texture features are associated with overall survival in pancreatic ductal adenocarcinoma – a quantitative analysis

BMC Medical Imaging ◽

10.1186/s12880-017-0209-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 56

Author(s):

Armin Eilaghi ◽

Sameer Baig ◽

Yucheng Zhang ◽

Junjie Zhang ◽

Paul Karanicolas ◽

...

Keyword(s):

Overall Survival ◽

Quantitative Analysis ◽

Pancreatic Ductal Adenocarcinoma ◽

Texture Features ◽

Ductal Adenocarcinoma

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Pyruvate Kinase Muscle Isoenzyme 2 (PKM2) Expression Is Associated with Overall Survival in Pancreatic Ductal Adenocarcinoma

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-015-9764-6 ◽

2015 ◽

Vol 46 (4) ◽

pp. 390-398 ◽

Cited By ~ 14

Author(s):

Natalie A. Lockney ◽

Manchao Zhang ◽

Yanzhen Lu ◽

Sabrina C. Sopha ◽

M. Kay Washington ◽

...

Keyword(s):

Overall Survival ◽

Pancreatic Ductal Adenocarcinoma ◽

Pyruvate Kinase ◽

Ductal Adenocarcinoma

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Precursors of pancreatic cancer in background of chronic opisthorchiasis

Medical Science And Education Of Ural ◽

10.36361/1814-8999-2021-22-1-118-121 ◽

2021 ◽

Vol 22 (1) ◽

pp. 118-121

Author(s):

V. U. Rayn ◽

◽

M. A. Persidskiy ◽

E. V. Malakhova ◽

I. V. Anuchina ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Pancreatic Ductal Adenocarcinoma ◽

Disease Free Survival ◽

Morphological Data ◽

Small Samples ◽

Ductal Adenocarcinoma ◽

Preneoplastic Lesions ◽

Opisthorchis Felineus ◽

Disease Free

Aim. To establish the association between pancreatic cancer precursor lesions and chronic opisthorchiasis. Materials and methods. A single center case-control study was conducted at a low-volume pancreatic surgery center in Khanty-Mansiysk. We retrospectively collected morphological data from 47 pancreatoduodenectomies performed for pancreatic ductal adenocarcinoma. The study group included 23 cases of pancreatic ductal adenocarcinoma with concomitant chronic Opisthorchis felineus invasion which were compared to 24 controls consisting of “pure” cancer. Qualitative analysis was performed using χ2 Pearson criterion. Exact Fisher test was used for small samples. Time to progression and overall survival rates were calculated using Kaplan-Meier survival analysis. Data were collected and analyzed in Statistica 7.0. Results. PanINs were seen in 41,7% pancreata resected for ductal adenocarcinoma of the head and in 95,7% cases of pancreatic cancer in background of chronic opisthorchiasis (р = 0,000; 95% CI 3,5-268). PanIN high grade were observed only in opisthorchiasis group. In mixed pathology invasive cancer component tended to be more dedifferentiated and advanced when compared to pure cancer group (p = 0,029). Median disease free survival was 9 mo. in both groups and overall survival was 13 mo. in non-opisthorchiasis group and 15,3 mo. in opisthorchiasis group (р = 0,437). Conclusion. Chronic opisthorchiasis is associated with pancreatic intraepithelial neoplasia. Pancreatic ductal adenocarcinoma in background of opisthorchiasis with preneoplastic lesions tend to be more advanced in stage and poorly differentiated. Disease free and overall survival have no statistically significant differences in patients with and without Opisthorchis felineus invasion.

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Hyaluronan heterogeneity in pancreatic ductal adenocarcinoma, primary tumors, and sites of metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16231 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16231-e16231

Author(s):

Veronica Placencio-Hickok ◽

Marie Lauzon ◽

Natalie Moshayedi ◽

Michelle Guan ◽

Sungjin Kim ◽

...

Keyword(s):

Overall Survival ◽

Liver Metastasis ◽

Regression Model ◽

Cox Regression ◽

Progression Free Survival ◽

Ductal Adenocarcinoma ◽

High Status ◽

Free Survival ◽

Pdac Tissue ◽

Treatment Naïve

e16231 Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers with an estimated five-year survival rate of 10%. The dense desmoplastic stroma in PDAC contributes to its aggressive nature and treatment resistance. Among the components comprising the stroma, hyaluronan (HA) has been demonstrated to play a critical role in tumor progression and survival. Previous preliminary studies have suggested differences in HA expression in primary and metastatic foci in PDAC. However, the effects of treatment and location of HA expression as well as the role of CD44, a known receptor for HA, on HA as a biomarker signature remain unknown. Thus, we investigated the potential of HA as a biomarker in primary PDAC and metastases. Methods: PDAC tissue from primary (n = 43) and metastatic (n = 66) sites were obtained from Cedars-Sinai Medical Center along with associated clinical data. Tissue slides were stained with H&E, HA using a histochemical assay, and CD44 by immunohistochemistry. HA staining was scored according to the proportion of stromal staining at an intensity greater than the background stroma. HA status was defined as ≥ 50% staining being HA high and < 50% as being HA low. CD44 staining was recorded as an H-score (percentage of tumor cells staining multiplied by intensity of staining on a scale from 0 to 3). Associations between HA levels and the requested variables were examined with t-test, Wilcoxon rank-sum test, Chi-squared test, Fisher’s exact test, or Cox regression model where appropriate. Kaplan-Meier curves were created to assess progression free survival and overall survival. Analyses were performed using SAS 9.4 with two-sided tests and a significance level of 0.05. Results: HA score was significantly higher in primary PDAC tissue compared to sites of metastases (p = 0.0148). Within the metastases, HA score was significantly higher in liver metastasis compared to other sites of metastasis (p = 0.0478). In the liver metastasis tissue, HA score trended lower in patients with previously treated tissue compared to treatment naïve tissue (p = 0.0622). In the treatment naive liver metastasis cohort, patients with HA high status had decreased progression free survival and overall survival compared to patients with HA low status (p = 0.0032 and p = 0.0478, respectively). Using HA score and CD44 in a Cox regression model demonstrated that for every one unit increase in HA score, the risk for recurrence/progression increased by 4.4% at any fixed point in time, adjusting for CD44 score (p = 0.0049). Conclusions: HA score is variable between primary PDAC, PDAC metastatic to the liver, and PDAC metastatic to other sites. Within liver metastases, patients with HA high status had decreased progression free survival and overall survival compared to patients with HA low status. HA levels can serve as a potential biomarker to guide pancreatic cancer treatments and trial design for agents targeting the stroma.

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Blood group has no bearing on overall survival of patients with pancreatic ductal adenocarcinoma

HPB ◽

10.1016/j.hpb.2019.03.225 ◽

2019 ◽

Vol 21 ◽

pp. S127-S128

Author(s):

H. Williams ◽

M.R. Jajja ◽

S. Hashmi ◽

K. Cardona ◽

S.K. Maithel ◽

...

Keyword(s):

Overall Survival ◽

Pancreatic Ductal Adenocarcinoma ◽

Blood Group ◽

Ductal Adenocarcinoma

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Higher BMI Indicated Better Overall Survival Prognosis of Pancreatic Ductal Adenocarcinoma: A Real-World Study Based on 2,010 Cases

10.21203/rs.3.rs-275720/v1 ◽

2021 ◽

Author(s):

Ningzhen FU ◽

Yu JIANG ◽

Kai QIN ◽

Xiaxing DENG ◽

Hao CHEN ◽

...

Keyword(s):

Overall Survival ◽

Pancreatic Ductal Adenocarcinoma ◽

Categorical Data ◽

High Volume ◽

World Health ◽

Ductal Adenocarcinoma ◽

Survival Prognosis ◽

Chemotherapy Administration ◽

High Volume Center ◽

Health Organization

Abstract Background: Whether body mass index (BMI) was associated with the overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) remained controversial and uncertain.Method: A total of 2,010 patients from single high-volume center were enrolled in the study. OS of PDAC patients was evaluated based on restricted cubic spline (RCS), propensity score (PS) and multivariable risk adjustment analyses. Result: BMI was discovered linear related with OS (total P=0.004, non-linear P=0.124). BMI was analyzed as categorical data based on X-tile software defined cutoffs and World Health Organization (WHO) recommended cutoffs, respectively. Adjusted with confounding covariates, higher BMI manifested as a positive prognostic predictor. (PXtile=0.003, PWHO=0.002) Furtherly, BMI was proven associated with OS in PS analysis. (UnderweightXtile vs. NormalXtile P=0.003, OverweightXtile vs. NormalXtile P=0.019; UnderweightWHO vs. NormalWHO P<0.001, OverweightWHO vs. NormalWHO P=0.024). It was also revealed that patients with higher BMI benefitted more from chemotherapy.(adjusted hazard ratio (aHR): UnderweightXtile: 0.565 (0.389-0.819), NormalXtile: 0.474 (0.395-0.567), OverweightXtile: 0.409 (0.337-0.496); UnderweightWHO: 0.613 (0.401-0.940), NormalWHO: 0.464 (0.387-0.557), OverweightWHO: 0.425 (0.353-0.512)). Conclusion: Among PDAC patients, higher BMI manifested as a favorable OS indicator, and the protective impact was probably based on chemotherapy administration. Patients with higher BMI were also observed with more chemotherapy administration and more OS benefits from chemotherapy.

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Sa1380 - A Decrease in T-Stage from Eus Guided Diagnosis to Time of Resection is Predictive of Overall Survival in Patients with Pancreatic Ductal Adenocarcinoma

Gastroenterology ◽

10.1016/s0016-5085(18)31311-8 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-285

Author(s):

Rohit Das ◽

Natalie Seiser ◽

Kevin McGrath ◽

Randall Brand ◽

Jennifer S. Chennat ◽

...

Keyword(s):

Overall Survival ◽

Pancreatic Ductal Adenocarcinoma ◽

Ductal Adenocarcinoma ◽

T Stage

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The Role of Nanoliposomal Irinotecan Plus Fluorouracil and Folinic Acid as Second-Line Treatment Option in Patients With Metastatic Pancreatic Ductal Adenocarcinoma

10.21203/rs.3.rs-489414/v1 ◽

2021 ◽

Author(s):

Se Jun Park ◽

Hyunho Kim ◽

Kabsoo Shin ◽

Tae Ho Hong ◽

Ja Hee Suh ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Adverse Events ◽

Pancreatic Ductal Adenocarcinoma ◽

Real World ◽

Median Overall Survival ◽

Ductal Adenocarcinoma ◽

Nanoliposomal Irinotecan ◽

Previously Treated ◽

Grade 3

Abstract BackgroundAccording to the NAPOLI-1 trial, nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) showed improved overall survival compared to fluorouracil alone for patients with metastatic pancreatic cancer who previously treated gemcitabine-based therapy. In that trial, Asian patients had frequent dose modification due to hematological toxicity. There has been limited information on the clinical benefit and toxicity of this regimen in a real-world setting. Herein, we assessed real-world experience of nal-IRI plus 5-FU/LV in patients with advanced pancreatic cancer after gemcitabine failure.MethodsWe conducted a single institution retrospective analysis of response, survival and safety in patients who had been treated with nal-IRI with 5-FU/LV. Patients with metastatic pancreatic ductal adenocarcinoma previously treated with gemcitabine-based therapy received nal-IRI (80mg/m2) with 5-FU/LV every 2 weeks. ResultsFifty-one patients received nal-IRI plus 5-FU/LV between January 2015 and December 2020. The median age was 67 years, and males were 58.8%. A total of 40 (78.4%) and 11 (21.6%) patients had received one and two lines of prior chemotherapy before enrollment, respectively. Median progression-free survival was 2.8 months (95% confidence interval [CI] 1.8-3.7) and median overall survival was 7.0 months (95% CI 6.0-7.9). Chemotherapy doses were reduced or delayed in 33 (64.7%) patients during the first 6 weeks and median relative dose intensity was 0.87. Thirty-six (70.6%) patients experienced any grade 3 or 4 adverse events. Most common grade 3 or 4 adverse event was neutropenia (58.8%) and most non-hematologic adverse events were under grade 2. Since the start of first-line chemotherapy, median overall survival was 16.3 months (95% CI 14.1-18.4).ConclusionsNal-IRI plus 5-FU/LV seems to be effective, with manageable toxicities, after gemcitabine-based treatment in patients with metastatic pancreatic ductal adenocarcinoma. Trial registration Retrospectively registered

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