title: Survival analysis of 272 patients with pancreatic cancer undergoing combined treatment.
abstract: BACKGROUND
  In China, traditional Chinese herbal medicine (TCHM) has been widely used for pancreatic cancer. This retrospective, matched case-control study aimed to assess factors affecting the survival time of patients with pancreatic cancer.
  
  
  METHODS
  From 2004 to 2012, a total of 411 patients with pathologically confirmed pancreatic cancer were enrolled, and 272 patients were matched and divided into TCHM and non-TCHM groups (control group) based on received TCHM or not. The match was according to gender, age of onset, radiotherapy, and chemotherapy. Both groups received comprehensive treatments, the TCHM group simultaneously received the TCHM spleen-invigorating compound for more than 3 months. The Cox model was used for prognostic factor analysis and the Kaplan-Meier method for estimating median overall survival (OS) and disease-free survival (DFS).
  
  
  RESULTS
  In 130 patients with advanced pancreatic cancer, COX analysis showed the Karnofsky Performance Scale (KPS; P = .000), radiotherapy (P = .003), and TCHM (P = .001) were independent prognostic factors for OS, with median OS of 12.7 and 9.9 months in TCHM and non-TCHM groups, respectively (hazard ratio [HR] = 0.520; 95% confidence interval [CI] = 0.353-0.766; P = .033). In 142 patients undergoing radical surgery, KPS (P = .000) and TCHM (P = .000) were independent prognostic factors for OS and DFS, median OS was 23.8 and 12.4 months in TCHM and non-TCHM groups, respectively (HR = 0.373; 95% CI = 0.251-0.554; P = .000), and the median DFS was 21.5 and 10.2 months in TCHM and non-TCHM groups, respectively (HR = 0.352; 95% CI = 0.237-0.522; P = .000).
  
  
  CONCLUSIONS
  KPS was an important prognostic factor of pancreatic cancer. Spleen-invigorating compounds could have an effect on improving the prognosis of pancreatic cancer patients.
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Nida
authors.initials: N
authors.lastname: Cao
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China aiguang@hotmail.com.
authors.forename: Aiguang
authors.initials: A
authors.lastname: Zhao
authors.affiliation: Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Shanghai Fudan University, Shanghai, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China Beijing Hui People's Hospital, Beijing, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China National Cancer Institute, Ministry of Health Malaysia, Putrajaya, Malaysia.
authors.forename: Renji
authors.initials: R
authors.lastname: Lin
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China Beijing Fangshan Traditional Chinese Medicine Hospital, Beijing, China.
authors.forename: Yadong
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Shanghai University of Traditional Chinese Medicine, Shanghai, China.
authors.forename: Jinkun
authors.initials: J
authors.lastname: Yang
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002681:China; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
keywords: matched case-control study; overall survival; pancreatic cancer; prognostic analysis; traditional Chinese medicine