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Prognostic factors in patients with gemcitabine-refractory pancreatic cancer.

AbstractOBJECTIVE: The purpose of this study was to identify prognostic factors in patients with gemcitabine-refractory pancreatic cancer and to determine criteria for selecting candidates for second-line treatment. METHODS: The records of 74 patients who were treated with gemcitabine (GEM) and followed up until disease progression were reviewed retrospectively. Sixteen clinical variables at the time of disease progression after GEM chemotherapy were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULTS: At the time of analysis, 71 patients had died because of tumor progression. The overall median survival time was 5.1 months after first-line chemotherapy with GEM was initiated. Median survival time after disease progression was 2.0 months. Three factors, performance status, peritoneal dissemination and C-reactive protein level, were identified as independent prognostic factors in multivariate analysis. Median survival time in the good prognosis group (patients with performance status 0 or 1, no peritoneal dissemination and C-reactive protein <5.0 mg/dl) was 3.4 months. CONCLUSIONS: Performance status, serum level of C-reactive protein and peritoneal dissemination were identified as important prognostic factors in patients with GEM-refractory pancreatic cancer. These factors should be considered in determining the treatment following first-line chemotherapy in patients with advanced pancreatic cancer.
AuthorsKohei Nakachi, Junji Furuse, Hiroshi Ishii, Ei-ichiro Suzuki, Masahiro Yoshino (Affiliation: Division of Hepatobiliary and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. konakach at east.ncc.go.jp)
JournalJapanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 37 Issue 2 Pg. 114-20 (Feb 2007) ISSN: 1465-3621 Japan
PMID17272317 (Publication Type: Journal Article)
Chemical References
  • Antimetabolites, Antineoplastic
  • gemcitabine
  • Deoxycytidine
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic (therapeutic use)
  • Deoxycytidine (analogs & derivatives, therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms (drug therapy, mortality)
  • Prognosis
  • Proportional Hazards Models
  • Remission Induction
  • Survival Analysis
  • Treatment Failure