title: Faecal elastase-1 is an independent predictor of survival in advanced pancreatic cancer.
abstract: BACKGROUND
  The relationship between prognosis of advanced pancreatic cancer and exocrine secretion impairment is unknown.
  
  
  OBJECTIVE
  To investigate a possible correlation between faecal elastase-1 value and survival in advanced pancreatic cancer.
  
  
  METHODS
  194 patients with advanced pancreatic cancer were prospectively enrolled between 2007 and 2009 and underwent faecal elastase-1 measurement. Exocrine pancreatic secretion was defined as "moderately reduced" (faecal elastase-1: 100-200 μg/g), "severely reduced" (faecal elastase-1<100 and >20 μg/g) and "extremely reduced" (faecal elastase-1≤20 μg/g).
  
  
  RESULTS
  Median faecal elastase-1 was 204 μg/g (interquartile range 19; 489). Overall, 48 patients (25%) had an extremely reduced exocrine pancreatic secretion, 28 (14%) a severely reduced exocrine pancreatic secretion and 21 (11%) a moderately reduced exocrine pancreatic secretion. Patients with extremely reduced exocrine pancreatic secretion had higher rates of pancreatic head localizations (P<0.01) and of jaundice (P<0.01). Median overall survival was 10.5 months. Patients with faecal elastase-1≤20 μg/g had a worse prognosis (median survival: 7 versus 11 months, P=0.031). Presence of metastases (Hazard ratio 1.81, P<0.0001), haemoglobin ≤12 g/L (Hazard ratio 2.12, P=0.001), albumin ≤40 g/L (Hazard ratio 1.64, P=0.010) and FE-1≤20 μg/g (Hazard ratio 1.59 P=0.023) resulted as independent predictors of survival in advanced pancreatic cancer patients.
  
  
  CONCLUSIONS
  A low value of faecal elastase-1 is strongly correlated with a poor survival in advanced pancreatic cancer.
authors: Department of Surgery, University of Verona, Policlinico GB Rossi, Verona, Italy.
authors: Stefano
authors: S
authors: Partelli
authors: Luca
authors: L
authors: Frulloni
authors: Consolato
authors: C
authors: Minniti
authors: Claudio
authors: C
authors: Bassi
authors: Giuliano
authors: G
authors: Barugola
authors: Mirko
authors: M
authors: D'Onofrio
authors: Stefano
authors: S
authors: Crippa
authors: Massimo
authors: M
authors: Falconi
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000175:diagnosis*; D002352:Carrier Proteins / Q000032:analysis / Q000378:metabolism; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000209:etiology; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000378:metabolism* / Q000503:physiopathology; D010196:Pancreatic Elastase; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D002352:Carrier Proteins; D010196:Pancreatic Elastase; C017130:cholesterol-binding protein