Division of Hematology/Oncology, Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Hematol Oncol. 2009 Mar 16;2:13. doi: 10.1186/1756-8722-2-13.
Metastatic pancreatic adenocarcinoma has a short median overall survival (OS) of 5-6 months. However, a subgroup of patients survives more than 1 year. We analyzed the survival outcomes of this subgroup and evaluated clinical and pathological factors that might affect survival durations.
We identified 20 patients with metastatic or recurrent pancreatic adenocarcinoma who received single-agent gemcitabine and had an OS longer than 1 year. Baseline data available after the diagnosis of metastatic or recurrent disease was categorized as: 1) clinical/demographic data (age, gender, ECOG PS, number and location of metastatic sites); 2) Laboratory data (Hematocrit, hemoglobin, glucose, LDH, renal and liver function and CA19-9); 3) Pathologic data (margins, nodal status and grade); 4) Outcomes data (OS, Time to Treatment Failure (TTF), and 2 year-OS). The lowest CA19-9 levels during treatment with gemcitabine were also recorded. We performed a univariate analysis with OS as the outcome variable.
Baseline logarithm of CA19-9 and total bilirubin had a significant impact on OS (HR = 1.32 and 1.31, respectively). Median OS and TTF on gemcitabine were 26.9 (95% CI = 18 to 32) and 11.5 (95% CI = 9.0 to 14.3) months, respectively. Two-year OS was 56.4%, with 7 patients alive at the time of analysis.
A subgroup of patients with metastatic pancreatic cancer has prolonged survival after treatment with gemcitabine. Only bilirubin and CA 19-9 levels were predictive of longer survival in this population. Further analysis of potential prognostic and predictive markers of response to treatment and survival are needed.
转移性胰腺腺癌的中位总生存期（OS）较短，为 5-6 个月。然而，有一小部分患者的生存期超过 1 年。我们分析了这部分患者的生存结果，并评估了可能影响生存时间的临床和病理因素。
我们确定了 20 名接受单药吉西他滨治疗且 OS 超过 1 年的转移性或复发性胰腺腺癌患者。将转移性或复发性疾病诊断后可获得的基线数据分为以下几类：1）临床/人口统计学数据（年龄、性别、ECOG PS、转移部位的数量和位置）；2）实验室数据（红细胞压积、血红蛋白、血糖、乳酸脱氢酶、肾功能和肝功能以及 CA19-9）；3）病理数据（切缘、淋巴结状态和分级）；4）结果数据（OS、治疗失败时间（TTF）和 2 年 OS）。还记录了吉西他滨治疗期间最低的 CA19-9 水平。我们对 OS 作为结局变量进行了单因素分析。
基线对数 CA19-9 和总胆红素对 OS 有显著影响（HR 分别为 1.32 和 1.31）。吉西他滨的中位 OS 和 TTF 分别为 26.9（95%CI=18-32）和 11.5（95%CI=9.0-14.3）个月，2 年 OS 为 56.4%，分析时仍有 7 例患者存活。
接受吉西他滨治疗后，转移性胰腺腺癌的一小部分患者的生存期延长。在该人群中，只有胆红素和 CA 19-9 水平可预测更长的生存期。需要进一步分析潜在的预后和预测标志物，以评估对治疗和生存的反应。
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