Survival and prognostic factors of unresectable pancreatic cancer.
OBJECTIVE
The aim of this study was to evaluate the prognostic significance of clinical and laboratory variables, and to investigate survival benefits for different treatment modalities in unresectable pancreatic cancer.


BACKGROUND
The majority of pancreatic cancers are found to be unresectable. Therefore, estimations of prognosis and decisions of treatment modalities are important in optimizing the various aspects of care.


METHODS
Three hundred and forty unresectable locally advanced, or metastatic pancreatic cancer patients were enrolled from January 1998 to January 2005 at the Seoul National University Hospital.


RESULTS
One hundred and five patients received chemotherapy only and 59 patients received concurrent chemoradiotherapy (CCRT). Age, performance status, tumor location, initial CA 19-9 level, American Joint Committee on Cancer stage, and treatment modality (supportive care only, chemotherapy, vs. CCRT) were found to have prognostic significance for overall survival (OS) by univariate analysis, whereas initial CA 19-9 level, stage, and treatment modality were identified as independent prognostic factors by multivariate analysis. In subgroup analysis, stage III patients treated by CCRT (median OS, 10.4 mo) or chemotherapy alone (11.3 mo) showed survival benefit over supportive care (6.4 mo), and stage IV patients treated by chemotherapy alone (6.4 mo) showed survival benefit over supportive care (3.1 mo).


CONCLUSIONS
Initial CA 19-9, American Joint Committee on Cancer stage, and treatment modality were independent prognostic factors of OS, and the patients who received chemotherapy or CCRT showed better survival than those who received supportive care only.
Park
Joo Kyung
JK
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Yoon
Yong Bum
YB
Kim
Yong-Tae
YT
Ryu
Ji Kon
JK
Yoon
Won Jae
WJ
Lee
Sang Hyub
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood; D015331:Cohort Studies; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007275:Injections, Intravenous; D007723:Korea; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D012944:Social Support; D015996:Survival Rate; D016896:Treatment Outcome; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D018395:CA-19-9 Antigen; D003841:Deoxycytidine; D000093542:Gemcitabine