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Poster Display session 2

1169 - Association of combination of irreversible electroporation ablation and chemotherapy with outcomes of locally advanced pancreatic cancer: a large cohort study

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Pancreatic Adenocarcinoma

Presenters

Chaobin He

Citation

Annals of Oncology (2019) 30 (suppl_5): v253-v324. 10.1093/annonc/mdz247

Authors

C. He, C. He

Author affiliations

  • Department Of Hepatobiliary And Pancreatic Surgery, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN

Resources

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Abstract 1169

Background

Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE combined with chemotherapy and chemotheraoy alone for patients with LAPC.

Methods

Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE combined with chemotherapy and chemotheraoy alone for patients with LAPC.

Results

Before PSM analysis, patients with LAPC had better overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) after IRE combined with chemotherapy compared with chemotherapy alone (median OS, 16.0 months vs 8.0 months in SEER dataset, P < 0.001, 21.6 months vs 7.1 months in SYSUCC dataset, P = 0.006; median CSS, 18 months vs 8 months, P < 0.001; median PFS, 7.7 months vs 4.9 months, P = 0.001). Multivariate Cox regression analysis indicated that IRE combined with chemotherapy was identified as a significant prognostic factor for OS, CSS and PFS in LAPC patients of both the whole cohort and the matched cohort.Table: 703P

Univariate and multivariate analyses of OS in patients

CharacteristicBefore PSMAfter PSM
Univariate analysisMultivariate analysisUnivariate analysisMultivariate analysis
HR95%CIPHR95%CIPHR95%CIPHR95% CIP
SEER dataset
Age (years)≤ 60 / > 601.2951.193-1.406<0.0011.2811.180-1.391<0.0011.3041.186-1.435<0.0011.2831.166-1.412<0.001
GenderFemale / Male0.9990.928-1.0750.984NI0.9940.914-1.0820.895NI
RaceBlack / White / Others0.9490.876-1.0270.194NI0.9370.855-1.0260.159
Tumor size (cm)≤ 2 / 2∼4 / >41.1371.066-1.213<0.0011.1481.075-1.225<0.0011.1351.054-1.2220.0011.1381.056-1.2260.001
Tumor gradeWell / Moderate / Poor1.1151.048-1.1860.0011.0771.012-1.1470.0191.1191.043-1.2000.0021.0811.007-1.1600.032
LN metastasisAbsent / Present1.0760.996-1.1620.064NI1.0720.981-1.1720.123NI
Tumor siteHead / Body / Tail0.9560.909-1.0060.082NI0.9600.960-1.0160.157NI
RadiotherapyNo / Yes0.6400.592-0.691<0.0010.6100.565-0.660<0.0010.6300.572-0.694<0.0010.6080.552-0.671<0.001
ChemotherapyWithout IRE / With IRE0.4280.351-0.522<0.0010.3690.302-0.451<0.0010.4030.329-0.492<0.0010.3700.302-0.453<0.001
SYSUCC dataset
Age (years)≤ 60 / > 601.1540.600-2.2220.668NI0.8890.351-0.2530.804NI
GenderFemale / Male2.3991.077-5.3430.052NI4.6301.317-16.2750.0174.9751.081-22.8910.039
Tumor size (cm)≤ 2 / 2∼4 / >41.6570.843-3.2570.143NI2.8631.021-8.0330.0462.0120.764-5.2940.157
Tumor gradeWell / Moderate / Poor1.1820.669-2.0860.565NI1.7970.680-3.2930.316NI
LN metastasisAbsent / Present7.9663.285-19.315<0.0014.0911.484-11.2780.0067.2642.220-23.7750.0014.7991.173-19.6250.029
Tumor siteHead / Body / Tail1.3170.879-1.9730.182NI1.3100.700-2.4520.398NI
WBC (*109)≤ 10 / > 101.0580.371-3.0190.916NI0.4630.061-3.5270.457NI
HGB (g/L)≤ 120 / > 1200.8520.419-1.7330.659NI1.4010.461-4.2640.552NI
PLT (*109)≤ 300 / > 3000.5130.181-1.4550.209NI0.4840.110-2.1260.337NI
ALT (U/L)≤ 40 / > 400.9290.435-1.9810.848NI1.0340.365-2.9290.950NI
AST (U/L)≤ 40 / > 401.0060.417-2.4280.989NI0.6230.143-2.7190.529NI
ALP (U/L)≤ 100 / > 1001.6860.867-3.2770.124NI1.3950.549-3.5460.484NI
GGT (U/L)≤ 45 / > 451.6460.840-3.2240.146NI2.1060.821-5.4000.121NI
ALB (g/L)≤ 40 / > 400.2610.133-0.5150.101NI0.4370.153-1.2440.121NI
TBIL (umol/L)≤ 20.5 / > 20.50.7120.296-1.7150.449NI0.3600.083-1.5690.174NI
IBIL (umol/L)≤ 15 / > 150.3540.048-2.5890.306NI0.0430.001-77.5250.411NI
CRP (ng/L)≤ 3 / > 33.3121.582-6.9360.0011.7410.757-4.0050.1923.0941.136-8.4280.127NI
CEA (ng/mL)≤ 5 / > 51.0290.527-2.0110.933NI1.2640.495-3.2320.624NI
CA19-9 (U/ml)≤ 35 / > 351.7450.676-4.5070.250NI1.7140.494-5.9510.396NI
HBsAgNegative/Positive0.2200.030-1.6100.136NI0.2640.094-0.7380.011NI
ChemotherapyWithout IRE/ With IRE0.2060.082-0.5150.0010.3630.132-0.9980.0500.2640.094-0.7380.0110.3130.098-0.9920.048
Cheotherapy typeFOLFIRINOX/Gem0.9100.648-1.2770.584NI0.8520.513-1.4140.535NI

Conclusions

IRE combined with chemotherapy is superior to chemotherapy alone in terms of OS, CSS and PFS for patients with LAPC. This combination method may be a more suitable way of treatment for patients with LAPC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The National Natural Science Funds (No. 81672390) and the National Key Research and Development Plan (No.2017YFC0910002).

Disclosure

All authors have declared no conflicts of interest.

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