A Case of Mucin-producing Pancreatic Cancer with Long-term Survival Following Operation.

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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Long-term survival benefit of upfront chemotherapy in patients with newly diagnosed borderline resectable pancreatic cancer

Cancer Medicine ◽

10.1002/cam4.1104 ◽

2017 ◽

Vol 6 (7) ◽

pp. 1552-1562 ◽

Cited By ~ 12

Author(s):

Bikram Shrestha ◽

Yifei Sun ◽

Farzana Faisal ◽

Victoria Kim ◽

Kevin Soares ◽

...

Keyword(s):

Pancreatic Cancer ◽

Survival Benefit ◽

Newly Diagnosed ◽

Resectable Pancreatic Cancer ◽

Borderline Resectable ◽

Term Survival ◽

Long Term Survival ◽

Borderline Resectable Pancreatic Cancer

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Long-term survival of pancreatic cancer patients treated with multimodal therapy combined with WT1-targeted dendritic cell vaccines

Human Vaccines & Immunotherapeutics ◽

10.1080/21645515.2018.1524238 ◽

2018 ◽

Vol 15 (2) ◽

pp. 397-406 ◽

Cited By ~ 3

Author(s):

Shuichi Hanada ◽

Tomoko Tsuruta ◽

Kouichi Haraguchi ◽

Masato Okamoto ◽

Haruo Sugiyama ◽

...

Keyword(s):

Pancreatic Cancer ◽

Dendritic Cell ◽

Cancer Patients ◽

Multimodal Therapy ◽

Term Survival ◽

Long Term Survival ◽

Dendritic Cell Vaccines

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Morbidity, mortality and long term survival in patients with vascular resection in pancreatic cancer – single center experience

Neoplasma ◽

10.4149/neo_2017_318 ◽

2017 ◽

Vol 64 (03) ◽

pp. 460-463 ◽

Cited By ~ 3

Author(s):

D. Pindak ◽

M. Tomas ◽

J. Dolnik ◽

R. Duchon ◽

J. Pavlendova

Keyword(s):

Pancreatic Cancer ◽

Vascular Resection ◽

Single Center ◽

Term Survival ◽

Long Term Survival ◽

Single Center Experience

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Long-term survival in patients with pancreatic cancer: Relevant factors in CONKO-001.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4020 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4020-4020 ◽

Cited By ~ 2

Author(s):

Marianne Sinn ◽

Bruno Valentin Sinn ◽

Jana Kaethe Striefler ◽

Jens Stieler ◽

Marco Niedergethmann ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Active Treatment ◽

Odds Ratio ◽

Univariate Analysis ◽

Tumor Grading ◽

Term Survival ◽

Long Term Survival ◽

Relevant Factors

4020 Background: Long-term survival (LTS) in patients with pancreatic cancer is still rare, even in resectable and potentially curative stages. Few prospective data are available to identify predictive factors. The CONKO-001 study establishing adjuvant gemcitabine (GEM) may provide data to answer this question. Methods: CONKO-001 patients (pts) with an overall survival > 5 years were included in this analysis and compared to those with < 5 years. Central re-evaluation of the primary histology was done to confirm the diagnosis of pancreatic adenocarcinoma. Univariate analysis with the x²-test identified qualifying factors (p<0.10). Logistic regression with a stepwise selection process was used to investigate the influence of these covariates on LTS. Results: Of the 354 pts included in the intention-to-treat analysis of CONKO-001, 53 (15%) pts with an overall survival of more than 5 years could be identified, for 39 (74%) tumor specimens could be obtained. In 38 (97% of pts with LTS) the diagnosis of adenocarcinoma was confirmed, 1 showed a high-grade neuroendocrine tumor. Relevant factors for all 53 pts with LTS compared to remaining 301 non-LTS pts in univariate analysis were active treatment (GEM) (68% in LTS pts vs 48% in non-LTS pts; p=0.006), tumor grading (G1 17% vs 3%, G2 64% vs 55%, G3 17% vs 40%; p=0.000), tumor-size (T2 15% vs 9%, T3 74% vs 84%; p=0.004) and lymph nodes (N0 47% vs 25% N1 53% vs 74%; p=0.003. Significance could not be demonstrated for resection margin (R0 vs R1), sex, age, Karnofsky performance status (<80% vs 80% vs >80%) and CA 19-9 (40-100 U/ml vs <40 U/ml) at study entry. In the multivariate analysis tumor grading (gr) (odds ratio gr 3 vs gr 1=0.07; gr 3 vs gr 2= 0.38; p=0.017) and active treatment (odds ratio GEM vs observation=0.38; p=0.004) were the only independent prognostic factors. Conclusions: Long-term survival can be achieved in adenocarcinoma of the pancreas. In pts with completely resected pancreatic cancer, tumor grading and active treatment with GEM were the only predictive factor for LTS.

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The oncologic impact of pancreatic fistula after pancreatectomy in patients with pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.426 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 426-426

Author(s):

Manabu Kawai ◽

Yoshiaki Murakami ◽

Seiko Hirono ◽

Ken-Ichi Okada ◽

Fuyuhiko Motoi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Fistula ◽

Hazard Analysis ◽

High Volume ◽

Postoperative Management ◽

Proportional Hazard ◽

Term Survival ◽

Long Term Survival ◽

Cox Proportional Hazard

426 Background: There is a few reports that evaluates the association between pancreatic and long-term survival after pancreatectomy in patients with pancreatic cancer. The aim of this study was to elucidate the oncological impact of pancreatic fistula (PF) on long-term survival after pancreatectomy in patients with pancreatic cancer by performing a survey of high volume centers for pancreatic resection in Japan. Methods: Between January 2001 and December 2012, 1,369 patients who underwent pancreatectomy for pancreatic cancer at 7 high-volume centers in Japan were retrospectively reviewed. Results: Pancreatic fistula(PF) occurred in 320 of 1,369 patients (23.5%), and these were classified based ISGPF as follows; grade A in 10.2%, grade B in 10.7%, and grade C in 2.6% of the patients. Median survival time (MST) in no fistula/grade A, grade B and grade C were 24.0, 26.3 and 11.0 months, respectively. MST in grade B PF was similar with that in no fistula/grade A. However, patients with grade C PF had a significantly poorer survival than those without (P<0.001). In the multivariate cox proportional hazard analysis, grade C PF was detected as an independent prognostic factor after pancreatectomy for pancreatic cancer (hazard ratio (HR) 2.15; 95% confidence interval (CI) 1.40-3.29; P< 0.001). Conclusions: Grade C PF adversely affects long-term survival of patients with pancreatic cancer undergoing pancreatectomy, although patients with grade B PF have similar prognosis with no fistula/grade A. Postoperative management to prevent grade C PF is important to improve prognosis in patients with pancreatic cancer undergoing pancreatectomy.

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Current State of Vascular Resections in Pancreatic Cancer Surgery

Gastroenterology Research and Practice ◽

10.1155/2015/120207 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 22

Author(s):

Thilo Hackert ◽

Lutz Schneider ◽

Markus W. Büchler

Keyword(s):

Pancreatic Cancer ◽

Adjuvant Treatment ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Treatment Strategies ◽

Western World ◽

Term Survival ◽

Long Term Survival ◽

Current State

Pancreatic cancer (PDAC) is the fourth leading cause of cancer-related mortality in the Western world and, even in 2014, a therapeutic challenge. The only chance for long-term survival is radical surgical resection followed by adjuvant chemotherapy which can be performed in about 20% of all PDAC patients by the time of diagnosis. As pancreatic surgery has significantly changed during the past years, extended operations, including vascular resections, have become more frequently performed in specialized centres and the border of resectability has been pushed forward to achieve a potentially curative approach in the respective patients in combination with neoadjuvant and adjuvant treatment strategies. In contrast to adjuvant treatment which has to be regarded as a cornerstone to achieve long-term survival after resection, neoadjuvant treatment strategies for locally advanced findings are currently under debate. This overview summarizes the possibilities and evidence of vascular, namely, venous and arterial, resections in PDAC surgery.

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