Improvement of long-term outcomes in pancreatic cancer and its associated factors within the gemcitabine era: a collaborative retrospective multicenter clinical ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-08-31

AUTHORS

Taira Kuroda, Teru Kumagi, Tomoyuki Yokota, Hirotaka Seike, Mari Nishiyama, Yusuke Imai, Nobu Inada, Naozumi Shibata, Satoshi Imamine, Shin-ichi Okada, Mitsuhito Koizumi, Hirofumi Yamanishi, Nobuaki Azemoto, Jiro Miyaike, Yoshinori Tanaka, Haruka Tatsukawa, Hiroki Utsunomiya, Yoshinori Ohno, Teruki Miyake, Masashi Hirooka, Shinya Furukawa, Masanori Abe, Yoshiou Ikeda, Bunzo Matsuura, Yoichi Hiasa, Morikazu Onji

ABSTRACT

BackgroundAlthough the outcomes of pancreatic cancer have been improved by gemcitabine, the changes in its characteristics and long-term outcomes within the gemcitabine era remain unclear. This study was conducted to identify clinical characteristics of pancreatic cancer patients within the gemcitabine era.MethodsA retrospective chart review was performed at 10 centers for 1,248 consecutive patients who were ever considered to have a diagnosis of pancreatic cancer between 2001 and 2010. Data collected included demographics, diagnosis date, clinical stage, treatment, and outcome; 1,082 patients met the inclusion criteria and were analyzed further. The chi-square test, Student’s t-test, and Mann–Whitney U-test were used for statistical analysis. Outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards regression. Differences in survival analyses were determined using the log-rank test.ResultsThe distribution of clinical stages was: I, 2.2%; II, 3.4%; III, 13%; IVa, 27%; and IVb, 55%. Chemotherapy alone was administered to 42% of patients and 17% underwent resection. The 1-, 3-, and 5-year survival rates were 39%, 13%, and 6.9%, respectively. The median survival time was 257 days, but differed considerably among treatments and clinical stages. Demographics, distribution of clinical stage, and cause of death did not differ between groups A (2001–2005, n = 406) and B (2006–2010, n = 676). However, group B included more patients who underwent chemotherapy (P < 0.0001) and fewer treated with best supportive care (P = 0.0004), mirroring improvements in this group’s long-term outcomes (P = 0.0063). Finally, factors associated with long-term outcomes derived from multivariate analysis were clinical stage (P < 0.0001), location of the tumor (P = 0.0294) and treatments (surgery, chemotherapy) (P < 0.0001).ConclusionsLong-term outcomes in pancreatic cancer has improved even within the gemcitabine era, suggesting the importance of offering chemotherapy to patients previously only considered for best supportive care. Most patients are still diagnosed at an advanced stage, making clinical strategy development for diagnosing pancreatic cancer at earlier stages essential. More... »

PAGES

134

Journal

TITLE

BMC Gastroenterology

ISSUE

1

VOLUME

13

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-230x-13-134

DOI

http://dx.doi.org/10.1186/1471-230x-13-134

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046584627

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24256464


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