Abstract 335P
Background
Patients with pancreatic cancer are usually diagnosed at an advanced stage and relapses are also frequent. Survival rates of metastatic pancreatic cancer remain poor.
Methods
This is a retrospective study of patients with histologically proven pancreatic adenocarcinoma treated in our department between 2001 and 2023. We aim to study the management, outcome and prognostic factors of these patients.
Results
A total of 238 patients were included, 172patients were metastatic (72.2%) and 106 of them Had synchronous metastases. Median age was 60 years old [32-81].60.4% of patients had good performance status [0-1]. Most tumors were localized in the head of pancreas (56.4%).28.5% developed metastases after curative surgery and 15.7 % after neoadjuvant chemotherapy for borderline/locally advanced tumor. 12.8 % underwent palliative surgery. 57% of our patients received a first-line treatment and 43% were unfit for chemotherapy. Gemcitabine and gemcitabine-cisplatin were the most frequently used regimens (respectively 48%and 17.3%). 77.9% of patients progressed, 9.5% had a stable disease, 12.6% experienced a partial radiological response. Median response after first-line chemotherapy was 4 months. Gemcitabinallowed better disease control rate (partial remission and stability) than gemcitabin CISPLATIN (respectively 8.5%, 5.3% p = 0.4). 15.7% of patients received second-line treatment. The two most commonly used regimens were gemcitabin (22.2%) and FOLFIRI (22.2%). Median response after second-line chemotherapy was 3 months. Gemcitabin seemed to be more effective than Folfiri (respectively 11.5% and 3.5 % of response rates, p = 0.03). Median overall survival (OS) and progression free survival (PFS) were respectively 6 and 5 months. On univariate analysis, factors associated with poor OS were elevated tumor markers (p = 0.015), metastases (p<0.0001). Those related with a better survival were receiving first (p<0.001) and second-line chemotherapy (p<0.0001). Multivariate analysis demonstrated that the only independent factor positively impacting survival was chemotherapy (p<0.0001).
Conclusions
This study confirms the survival benefit of palliative chemotherapy, but survival improvement remains poor compared to other gastrointestinal cancers.
Legal entity responsible for the study
Medical Oncology Department, University of Sousse.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.