title: Management of advanced pancreatic cancer in daily clinical practice.
abstract: OBJECTIVE
  The aim of this outcome study was to evaluate the management of advanced pancreatic cancer in a real-world clinical practice; few such experiences have been reported in the literature.
  
  
  METHODS
  A retrospective analysis was performed of all consecutive patients with advanced pancreatic ductal adenocarcinoma followed at our medical oncology unit between January 2003 and December 2013.
  
  
  RESULTS
  We evaluated 78 patients, mostly with metastatic disease (64.1%). Median follow-up was 10.77 months, by which time 74 patients (94.9%) had died. Median overall survival was 8.29 months. Median age was 67 years. In univariate analysis, pain at onset (p = 0.020), ECOG performance status (p&lt;0.001), stage (p = 0.047), first-line chemotherapy (p&lt;0.001), second-line chemotherapy (p&lt;0.001) and weight loss at diagnosis (p = 0.029) were factors that had an impact on overall survival. In multivariate analysis, the presence of pain at onset (p = 0.043), stage (p = 0.003) and second-line chemotherapy (p = 0.004) were confirmed as independent prognostic factors.
  
  
  CONCLUSIONS
  Our data, derived from daily clinical practice, confirmed advanced pancreatic cancer as an aggressive malignant disease with a very short expected survival. Second-line treatment seems to provide an advantage in terms of overall survival in patients who showed a partial response as their best response to first-line treatment.
authors.affiliation: Department of Medical Oncology, Mater Salutis Hospital, AULSS 21 della Regione Veneto, Legnago (Verona) - Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Giuliani
authors.affiliation: Department of Medical Oncology, Mater Salutis Hospital, AULSS 21 della Regione Veneto, Legnago (Verona) - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Piacentini
authors.affiliation: Department of Medical Oncology, Mater Salutis Hospital, AULSS 21 della Regione Veneto, Legnago (Verona) - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010146:Pain / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D015431:Weight Loss; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D009944:Organoplatinum Compounds; D003841:Deoxycytidine; D000093542:Gemcitabine