P-0108 - Prognostic Factors in Patients with Advanced Pancreatic Cancer Treated with Gemcitabine Chemotherapy: Clinical Characteristics of Long-term Survivors

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Presenter Uk Kim Dong
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors U. Kim Dong1, S. Park2, A. Jang3, S. Bang4, J. Cho5
  • 1Pusan National University, Busan/KR
  • 2Kosin University, Busan/KR
  • 3Youngsan University, Yangsan/KR
  • 4Yonsei University, Seoul/KR
  • 5Gachon University, Incheon/KR

Abstract

Introduction

Pancreatic cancer is a highly lethal disease. Most cancers are unresectable at diagnosis, and so gemcitabine chemotherapy has been the standard treatment in these cases. However, the response of gemcitabine chemotherapy varies from non-responder to long-term survivor. We retrospectively analyzed clinical characteristics of patients with locally advanced or metastatic pancreatic cancer who received gemcitabine-based chemotherapy and presented long-term survival.

Methods

We enrolled 49 patients who underwent treatment with more three cycles of gemcitabine-based chemotherapy from July, 207 to November 2012 in single center. Long-term survivor defined as patient who presents overall survival of more than 12 months. Univariate or multivariate analysis were used to identify prognostic factors associated with progression-free survival. Additionally, clinical characteristics were compared between long-term and short-term survivors.

Results

Median patient age was 61 years. Twenty nine patients were male (59%). Median overall and progression-free survival were 11 and 4 months, respectively. Twenty patients (41%) survived for more than 12 months. In univariate analysis, serum CEA level (p = 0.008), presence of distant metastasis (p = 0.010), CA19-9 level (p = 0.05) at diagnosis were predictors of poor disease progression-free survival. In multivariate analysis, serum CEA level (HR = 2.518, 95%CI: 1.156-5.482; p = 0.035), presence of distant (HR = 1.024, 95%CI: 1.002-1.046; p = 0.02) at diagnosis were independent predictors of progression-free survival. Long-term survivors demonstrated smaller tumor size (p = 0.04), and lower CA 19-9 level (p = 0.03) at diagnosis compared to short-term survivors in univariate analysis. However there were no clinically significant differences between two groups in multivariate analysis including presence of ascites, presence of carcinomatosis peritonei, tumor size, presence of distant metastasis, CEA level, CA 19-9 at diagnosis, and so on.

Conclusion

High serum CEA level and presence of distant metastasis at diagnosis were related with poor disease progression-free survival. However, there were no clinically significant differences between long-term and short-term survivors. Therefore, gemcitabine chemotherapy maybe allows longer survival in clinically severe advanced patients with carcinomatosis peritonei or distant metastasis. We need a well-designed controlled study about which patients are suitable for gemcitabine chemotherapy.