ESMO 2019 Congress | OncologyPRO

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

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

Characteristic	Before PSM	After PSM
Univariate analysis	Multivariate analysis	Univariate analysis	Multivariate analysis
HR	95%CI	P	HR	95%CI	P	HR	95%CI	P	HR	95% CI	P
SEER dataset
Age (years)	≤ 60 / > 60	1.295	1.193-1.406	<0.001	1.281	1.180-1.391	<0.001	1.304	1.186-1.435	<0.001	1.283	1.166-1.412	<0.001
Gender	Female / Male	0.999	0.928-1.075	0.984			NI	0.994	0.914-1.082	0.895			NI
Race	Black / White / Others	0.949	0.876-1.027	0.194			NI	0.937	0.855-1.026	0.159
Tumor size (cm)	≤ 2 / 2∼4 / >4	1.137	1.066-1.213	<0.001	1.148	1.075-1.225	<0.001	1.135	1.054-1.222	0.001	1.138	1.056-1.226	0.001
Tumor grade	Well / Moderate / Poor	1.115	1.048-1.186	0.001	1.077	1.012-1.147	0.019	1.119	1.043-1.200	0.002	1.081	1.007-1.160	0.032
LN metastasis	Absent / Present	1.076	0.996-1.162	0.064			NI	1.072	0.981-1.172	0.123			NI
Tumor site	Head / Body / Tail	0.956	0.909-1.006	0.082			NI	0.960	0.960-1.016	0.157			NI
Radiotherapy	No / Yes	0.640	0.592-0.691	<0.001	0.610	0.565-0.660	<0.001	0.630	0.572-0.694	<0.001	0.608	0.552-0.671	<0.001
Chemotherapy	Without IRE / With IRE	0.428	0.351-0.522	<0.001	0.369	0.302-0.451	<0.001	0.403	0.329-0.492	<0.001	0.370	0.302-0.453	<0.001
SYSUCC dataset
Age (years)	≤ 60 / > 60	1.154	0.600-2.222	0.668			NI	0.889	0.351-0.253	0.804			NI
Gender	Female / Male	2.399	1.077-5.343	0.052			NI	4.630	1.317-16.275	0.017	4.975	1.081-22.891	0.039
Tumor size (cm)	≤ 2 / 2∼4 / >4	1.657	0.843-3.257	0.143			NI	2.863	1.021-8.033	0.046	2.012	0.764-5.294	0.157
Tumor grade	Well / Moderate / Poor	1.182	0.669-2.086	0.565			NI	1.797	0.680-3.293	0.316			NI
LN metastasis	Absent / Present	7.966	3.285-19.315	<0.001	4.091	1.484-11.278	0.006	7.264	2.220-23.775	0.001	4.799	1.173-19.625	0.029
Tumor site	Head / Body / Tail	1.317	0.879-1.973	0.182			NI	1.310	0.700-2.452	0.398			NI
WBC (*10⁹)	≤ 10 / > 10	1.058	0.371-3.019	0.916			NI	0.463	0.061-3.527	0.457			NI
HGB (g/L)	≤ 120 / > 120	0.852	0.419-1.733	0.659			NI	1.401	0.461-4.264	0.552			NI
PLT (*10⁹)	≤ 300 / > 300	0.513	0.181-1.455	0.209			NI	0.484	0.110-2.126	0.337			NI
ALT (U/L)	≤ 40 / > 40	0.929	0.435-1.981	0.848			NI	1.034	0.365-2.929	0.950			NI
AST (U/L)	≤ 40 / > 40	1.006	0.417-2.428	0.989			NI	0.623	0.143-2.719	0.529			NI
ALP (U/L)	≤ 100 / > 100	1.686	0.867-3.277	0.124			NI	1.395	0.549-3.546	0.484			NI
GGT (U/L)	≤ 45 / > 45	1.646	0.840-3.224	0.146			NI	2.106	0.821-5.400	0.121			NI
ALB (g/L)	≤ 40 / > 40	0.261	0.133-0.515	0.101			NI	0.437	0.153-1.244	0.121			NI
TBIL (umol/L)	≤ 20.5 / > 20.5	0.712	0.296-1.715	0.449			NI	0.360	0.083-1.569	0.174			NI
IBIL (umol/L)	≤ 15 / > 15	0.354	0.048-2.589	0.306			NI	0.043	0.001-77.525	0.411			NI
CRP (ng/L)	≤ 3 / > 3	3.312	1.582-6.936	0.001	1.741	0.757-4.005	0.192	3.094	1.136-8.428	0.127			NI
CEA (ng/mL)	≤ 5 / > 5	1.029	0.527-2.011	0.933			NI	1.264	0.495-3.232	0.624			NI
CA19-9 (U/ml)	≤ 35 / > 35	1.745	0.676-4.507	0.250			NI	1.714	0.494-5.951	0.396			NI
HBsAg	Negative/Positive	0.220	0.030-1.610	0.136			NI	0.264	0.094-0.738	0.011			NI
Chemotherapy	Without IRE/ With IRE	0.206	0.082-0.515	0.001	0.363	0.132-0.998	0.050	0.264	0.094-0.738	0.011	0.313	0.098-0.992	0.048
Cheotherapy type	FOLFIRINOX/Gem	0.910	0.648-1.277	0.584			NI	0.852	0.513-1.414	0.535			NI

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.

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

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Abstract 1169

Background

Methods

Results

Conclusions

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

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Abstract 1169

Background

Methods

Results

Conclusions

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Funding

Disclosure

Resources from the same session