title: Rare long-term survivors of pancreatic adenocarcinoma without curative resection.
abstract: Long-term outcome data in pancreatic adenocarcinoma are predominantly based on surgical series, as resection is currently considered essential for long-term survival. In contrast, five-year survival in non-resected patients has rarely been reported. In this report, we examined the incidence and natural history of ≥ 5-year survivors with non-resected pancreatic adenocarcinoma. All patients with pancreatic adenocarcinoma who received oncologic therapy alone without surgery at our institution between 1995 and 2009 were identified. Non-resected ≥ 5-year survivors represented 2% (11/544) of all non-resected patients undergoing treatment for pancreatic adenocarcinoma, and 11% (11/98) of ≥ 5-year survivors. Nine patients had localized tumor and 2 metastatic disease at initial diagnosis. Disease progression occurred in 6 patients, and the local tumor bed was the most common site of progression. Six patients suffered from significant morbidities including recurrent cholangitis, second malignancy, malnutrition and bowel perforation. A rare subset of patients with pancreatic cancer achieve long-term survival without resection. Despite prolonged survival, morbidities unrelated to the primary cancer were frequently encountered and a close follow-up is warranted in these patients. Factors such as tumor biology and host immunity may play a key role in disease progression and survival.
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Stephen Y
authors.initials: SY
authors.lastname: Oh
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Alicia
authors.initials: A
authors.lastname: Edwards
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Mandelson
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Bruce
authors.initials: B
authors.lastname: Lin
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Russell
authors.initials: R
authors.lastname: Dorer
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: W Scott
authors.initials: WS
authors.lastname: Helton
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kozarek
authors.affiliation: Stephen Y Oh, Alicia Edwards, Richard A Kozarek, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, United States.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Picozzi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000368:Aged; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
keywords: 5-year survival; Chemotherapy; Cholangitis; Long-term survival; Malnutrition; Non-resected pancreatic cancer; Second malignancy