Overall survival of patients with recurrent pancreatic cancer treated with systemic therapy: a retrospective study

Abstract Background We designed a retrospective study to compare prognostic outcomes based on whether or not surgical resection was performed in elderly patients aged(≥75 years) with resectable pancreatic cancer. Methods We retrospectively analyzed 49 patients with resectable pancreatic cancer (surgery group, resection was performed for 38 cases; no surgery group, resection was not performed for 11 cases) diagnosed from January 2003 to December 2014 at the National Cancer Center, Korea. Results There was no significant difference in demographics between the two groups. The surgery group showed significantly better overall survival after diagnosis than the no surgery group (2-year survival rate, 40.7% vs. 0%; log-rank test, p = 0.015). Multivariate analysis revealed that not having undergone surgical resection [hazard ratio (HR) 2.412, P = 0.022] and a high Charlson comorbidity index (HR 5.252, P = 0.014) were independent prognostic factors for poor overall survival in elderly patients with early stage pancreatic cancer. Conclusions In the present study, surgical resection resulted in better prognosis than non-surgical resection for elderly patients with resectable pancreatic cancer. Except for patients with a high Charlson comorbidity index, an aggressive surgical approach seems to be beneficial for elderly patients with resectable pancreatic cancer.

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SO-1 Prognostic nomogram to predict overall survival in patients with unresectable pancreatic cancer treated with gemcitabine plus nab-paclitaxel or FOLFIRINOX: Real-world results from the multicenter retrospective study (NAPOLEON study)

Annals of Oncology ◽

10.1016/j.annonc.2020.04.016 ◽

2020 ◽

Vol 31 ◽

pp. S217

Author(s):

T. Shibuki ◽

T. Mizuta ◽

M. Shimokawa ◽

F. Koga ◽

Y. Ueda ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Real World ◽

Unresectable Pancreatic Cancer

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Definitive radiotherapy for patients with isolated local recurrence of primary resected pancreatic cancer: A retrospective analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.366 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 366-366

Author(s):

Akira Nakamura ◽

Keiko Shibuya ◽

Kyoichi Takaori ◽

Yoshiya Kawaguchi ◽

Michio Yoshimura ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Local Recurrence ◽

Local Control ◽

Local Control Rate ◽

Definitive Radiotherapy ◽

Recurrent Pancreatic Cancer ◽

Locally Recurrent ◽

Grade 3 ◽

Isolated Local Recurrence

366 Background: Only surgical resection can provide a chance of long-term survival for patients with pancreatic cancer, but loco-regional recurrence has been a major challenge which inevitably results in poor prognosis and loss of patients’ quality of life. Curative reoperation is seldom attainable but has been suggested to have benefits on overall survival. We hypothesized that definitive radiotherapy could offer a good control for the unresectable local recurrence and improve survival. The primary objective of this retrospective analysis is to evaluate the efficacy and tolerability of definitive radiotherapy for patients with isolated locally-recurrent pancreatic cancer. Methods: A total of 26 patients, who developed local recurrence of primarily resected pancreatic cancer and received radiotherapy between 2000 and 2011, were retrospectively analyzed. The isolated local recurrence was diagnosed with the radiological images (CT/MRI/PET) and tumor marker relapse. The overall survival (OS) and local control rate (LC) were calculated from the start day of radiotherapy and estimated by Kaplan-Meier method. The responses in tumor size and tumor markers were evaluated. The treatment-related toxicity was assessed according to CTC-AE (ver. 4.0). Results: The median total dose of radiotherapy was 50.4 Gy (range, 39.6–54 Gy). Concurrent chemotherapy consisted of gemcitabine (62%), S-1 (19%), and 5-fluorouracil (4%). At a median follow-up time of 13 months, the 1-year OS and median survival were 75% and 21.6 months, respectively. The 1-year local control rate was 59%. Objective radiological response was not seen. The tumor marker reduction and ≥ 50% reduction were observed in 65% and 12%. Grade≥3 hematological toxicity was seen in 62%. Grade ≥ 3 of acute gastrointestinal toxicity was not observed. At a late phase, Grade 3 ileus observed in one, and Grade 3 gastric bleeding ulcer was seen in one patient. Conclusions: Definitive radiotherapy resulted in encouraging local control and overall survival for patients with isolated locally-recurrent pancreatic cancer. This treatment strategy should be further evaluated prospectively.

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Gflip/ox in the treatment of advanced pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15192 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15192-e15192

Author(s):

Yashar Hirshaut ◽

Daniel Khalil ◽

Rachel V. Kramer ◽

Daniel Helfgott

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Dose Adjustment ◽

Median Overall Survival ◽

Advanced Pancreatic Cancer ◽

Sensory Neuropathy ◽

Phase 3 ◽

Recurrent Pancreatic Cancer ◽

M 12 ◽

Age Range

e15192 Background: GFLIP and GLIP/Ox (Bruckner et al. ASCO, 2008) are effective in the treatment of pancreatic cancer (Bruckner, et.al. ASCO, 2008). A similar regimen FOLFIRINOX proved successful in a Phase 3 trial (Conroy, T. et al. NEJM, 2011). However, these regimens are not widely used because of concerns about efficacy and/ or toxicity. Our experience suggests that with dose adjustment when necessary, GFLIP/Ox is both effective and well tolerated. Methods: This is a retrospective review of 24 patients (12 M, 12 F) with unresectable or recurrent pancreatic cancer. The drugs/doses used were leucovorin 300mg, gemcitabine 500mg/M2, irinotecan 80mg/M2, fluorouracil (FU) 400mg/M2 bolus, FU 600mg/M2 46 hr. infusion, oxaliplatin 35 mg/M2, bevacizumab 10mg/M2 +/- cetuximab 400mg/2 given q2 wks. Doses were reduced up to 50% for pts. >70 yrs. Results: 24 pts treated, 11 with cetuximab. Age range 44-87 yrs, mean 68.8 yrs. Response (RR) 38%, Disease Control (DC) 79%. PFS (19 pts) median 264 days (d). Median OS 382 d. Overall survival <70 yrs median 814 d. >70 yrs 304 d. With cetuximab (CTX) DC 91%, OS 512 d, without CTX DC 69%, OS 249 days. Side effects were fatigue, sensory neuropathy, anemia, neutropenia, generally grade 1-2. There was one case of grade 4 thrombocytopenia. There were no deaths attributable to chemotherapy. Conclusions: The median OS of this regimen is 12.7 mo. vs. 6.8 mo. for gemcitabine and 11.1 mo. for FOLFIRINOX. The RR of 38% compares favorably to the 31% RR for FOLFIRINOX. Taken together with the 27 month median overall survival among those under 70 (11 pts) makes GFLIP/Ox a regimen worth further study for this disease.

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Sarcopenia as a prognostic factor in patients with recurrent pancreatic cancer: a retrospective study

World Journal of Surgical Oncology ◽

10.1186/s12957-020-01981-x ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Teruhisa Sakamoto ◽

Takuki Yagyu ◽

Ei Uchinaka ◽

Kozo Miyatani ◽

Takehiko Hanaki ◽

...

Keyword(s):

Pancreatic Cancer ◽

Retrospective Study ◽

Prognostic Factor ◽

Recurrent Pancreatic Cancer

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Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer

Strahlentherapie und Onkologie ◽

10.1007/s00066-021-01827-9 ◽

2021 ◽

Author(s):

Jakob Liermann ◽

Edgar Ben-Josef ◽

Mustafa Syed ◽

Juergen Debus ◽

Klaus Herfarth ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Local Control ◽

Ion Beam ◽

Carbon Ion Radiotherapy ◽

Definitive Treatment ◽

Carbon Ions ◽

Carbon Ion ◽

Recurrent Pancreatic Cancer ◽

Locally Recurrent

Abstract Purpose Data on management of locally recurrent pancreatic cancer (LRPC) after primary resection are limited. Recently, surprisingly high overall survival rates were reported after irradiation with carbon ions. Here, we report on our clinical experience using carbon ion radiotherapy as definitive treatment in LRPC at the Heidelberg Ion-Beam Therapy Center (HIT). Methods Between 2015 and 2019, we treated 13 patients with LRPC with carbon ions with a median total dose of 48 Gy (RBE) in 12 fractions using an active raster-scanning technique at a rotating gantry. No concomitant chemotherapy was administered. Overall survival, local control, and toxicity rates were evaluated 18 months after the last patient finished radiotherapy. Results With a median follow-up time of 9.5 months, one patient is still alive (8%). Median OS was 12.7 months. Ten patients (77%) developed distant metastases. Additionally, one local recurrence (8%) and two regional tumor recurrences (15%) were observed. The estimated 1‑year local control and locoregional control rates were 87.5% and 75%, respectively. During radiotherapy, we registered one gastrointestinal bleeding CTCAE grade III (8%) due to gastritis. The bleeding was sufficiently managed with conservative therapy. No further higher-grade acute or late toxicities were observed. Conclusion We demonstrate high local control rates in a rare cohort of LRPC patients treated with carbon ion radiotherapy. The observed median overall survival rate was not improved compared to historical in-house data using photon radiotherapy. This is likely due to a high rate of distant tumor progression, highlighting the necessity of additional chemotherapy.

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Association between early nutritional risk and overall survival in patients with advanced pancreatic cancer: A single-center retrospective study

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2019.01.012 ◽

2019 ◽

Vol 30 ◽

pp. 94-99 ◽

Cited By ~ 2

Author(s):

Joung Soon Park ◽

Hyung-mi Kim ◽

Hei-Cheul Jeung ◽

Soon Ah Kang

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Advanced Pancreatic Cancer ◽

Nutritional Risk ◽

Single Center

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Repeated Pancreatectomy for Isolated Local Recurrence in the Remnant Pancreas Following Radical Pancreatectomy for Pancreatic Ductal Adenocarcinoma: A Pooled Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9123945 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3945

Author(s):

Munseok Choi ◽

Na Won Kim ◽

Ho Kyoung Hwang ◽

Woo Jung Lee ◽

Chang Moo Kang

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Local Recurrence ◽

Pooled Analysis ◽

Ductal Adenocarcinoma ◽

Time Interval ◽

Remnant Pancreas ◽

Recurrent Pancreatic Cancer ◽

Isolated Local Recurrence

The mainstream treatment for recurrent pancreatic cancer is potent chemotherapy or chemoradiotherapy. However, recent clinical investigations have suggested a potential oncologic role of local resection of recurrent pancreatic cancer. This systemic review with a pooled analysis aimed to assess the potential role of local repeated pancreatectomy with respect to the survival outcomes for patients with recurrent pancreatic ductal adenocarcinoma (PDAC) in the remnant pancreas. The PubMed database was searched, and 15 articles reporting on repeated pancreatectomy for local recurrence of PDAC in the remnant pancreas were identified. The pooled individual data were examined for the clinical outcomes of repeated pancreatectomy for recurrent PDAC. The survival analysis was performed using the Kaplan–Meier method. In the pooled analysis, the mean time interval from initial pancreatectomy to repeated pancreatectomy was 41.3 months (standard deviation (SD), 29.09 months). Completion total pancreatectomy was most commonly performed as repeated pancreatectomy (46 patients, 92.0%), and partial pancreatic resection was performed for only 4 (10.3%) patients. Twenty (40.9%) patients received postoperative chemotherapy following repeated pancreatectomy. The median overall survival was 60 months (95% confidential interval (CI): 45.99–74.01) after repeated pancreatectomy for isolated local recurrence in the remnant pancreas. Overall survival was markedly longer considering the timing of the initial pancreatectomy for pancreatic cancer (median, 107 months (95% CI: 80.37–133.62). The time interval between the initial and subsequent repeated pancreatectomy for pancreatic cancer was not associated with long-term oncologic outcomes (p = 0.254). Repeated pancreatectomy cannot completely replace adjuvant chemotherapy but should be considered for patients with isolated local recurrent PDAC in the remnant pancreas.

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Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v3i4.171 ◽

1970 ◽

Vol 3 (4) ◽

pp. 9-20

Author(s):

José Henrique Gomes Torres ◽

Rosyane Rena De Freitas

Keyword(s):

Pancreatic Cancer ◽

Retrospective Study ◽

Survival Rates ◽

Periampullary Tumor ◽

The Past ◽

Palliative Procedure ◽

Surgical Palliation ◽

Head Of The Pancreas ◽

Keywords Pancreatic Cancer ◽

Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente. Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos. Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication. Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care

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