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
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.
Resources from the same session
5747 - The routine use of sentinel lymph node biopsy in high risk DCIS lesions is not justified
Presenter: Fanny Preat
Session: Poster Display session 2
Resources:
Abstract
1837 - Oncological impact of re-excision for positive margin status after breast conserving surgery in invasive breast cancer
Presenter: Kenjiro Jimbo
Session: Poster Display session 2
Resources:
Abstract
4347 - Pneumonitis and fibrosis after breast cancer radiation.
Presenter: Jarle Karlsen
Session: Poster Display session 2
Resources:
Abstract
2280 - Prognosis of mastectomy with reconstruction after neoadjuvant chemotherapy: a nationwide study in Korean Breast Cancer Society
Presenter: Sungmin Park
Session: Poster Display session 2
Resources:
Abstract
804 - A negative prognosis of radiotherapy-induced lower lymphocyte to monocyte ratio in patients with breast cancer
Presenter: Chang-ik Yoon
Session: Poster Display session 2
Resources:
Abstract
2701 - Patient data to monitor clinical patterns in early and advanced breast cancer in Europe
Presenter: Francesco Giusti
Session: Poster Display session 2
Resources:
Abstract
1437 - A critical appraisal of quality indicators of breast cancer treatment in Belgium
Presenter: Didier Verhoeven
Session: Poster Display session 2
Resources:
Abstract
1534 - Predictors of adherence among post-menopausal women receiving adjuvant endocrine therapy for breast cancer in Ontario, Canada
Presenter: Phillip Blanchette
Session: Poster Display session 2
Resources:
Abstract
4363 - Evaluation of endocrine therapy and patients preferences in early breast cancer: results of Elena study
Presenter: Emilia Montagna
Session: Poster Display session 2
Resources:
Abstract
2679 - Baseline Quality of life (QoL) and chemotherapy related toxicities (CRT) in localized breast cancer (BC) patients (pts): the French multicentric prospective CANTO cohort study
Presenter: Idlir Licaj
Session: Poster Display session 2
Resources:
Abstract