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The survival of patients with radically non-resectable pancreatic cancer


Authors: L. Bébarová 2;  P. Skalický 2 ;  Dušan Klos 1 ;  R. Havlík 1;  Č. Neoral 1;  J. Zapletalová 3;  M. Loveček 2
Authors place of work: I. chirurgická klinika FN Olomouc přednosta: prof. MUDr. Č. Neoral, CSc. 1;  I. chirurgická klinika LF Univerzity Palackého Olomouc přednosta: prof. MUDr. Č. Neoral, CSc. 2;  Ústav lékařské biofyziky LF Univerzity Palackého a FN Olomouc přednostka: prof. RNDr. H. Kolářová, CSc. 3
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 6, s. 222-226.
Category: Original articles

Summary

Introduction:
Pancreatic cancer (PDAC) is one of the most aggressive malignancies. Its poor prognosis is due to a combination of various factors, mainly aggressive biology of the tumour, non-specific symptoms in early stages, their underestimation, prolonged time to diagnosis and late onset of treatment. The majority of patients are diagnosed in an advanced stage of the disease. Median survival of these patients ranges from 2−11 months. The most common consequences of locally advanced disease that require intervention include obstruction of the duodenum and biliary obstruction. The purpose of our study was to analyze the survival of patients with radically inoperable PDAC undergoing palliative surgery or exploration with biopsy, and to evaluate the influence of patient and tumour factors and treatment modalities on survival.

Methods:
In our retrospective study we included all patients with radically inoperable PDAC undergoing a non-radical surgical intervention between 01 January 2006 and 31 December 2014. Patient age, histopathological findings, surgical and oncological treatment and survival were included in the analysis. The results were statistically processed and evaluated using IBM SPSS Statistics software version 22 (USA).

Results:
184 patients with radically inoperable PDAC, 105 males and 79 females, were included in our study. Mean age of the patients was 64 years and most patients presented with stage IV of the disease. Mean survival time was 7.04 months and median 4.7 months.

Conclusion:
We determined a statistically significant influence of the following factors on patient survival: sex, stage, presence of distant metastases at the time of surgery and oncological treatment administration. Mean and median survival of patients with radically inoperable tumours matches global statistics.

Key words:
pancreatic cancer – radically non-resectable – palliative surgery – survival


Zdroje

1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer 2013;49:1374−1403.

2. www.svod.cz

3. Ryska M, Strnad R, Bělina F, et al. Radikální resekce u nemocných s karcinomem hlavy pankreatu. Retrospektivní analýza přežívání u souboru 307 nemocných. Rozhl Chir 2007;86:432−9.

4. Richter A, Niedergethmann M, Sturm JW, et al. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience. World J Surg 2003;27:324−9.

5. Neoptolemos JP, Urrutia R, Abbruzzese JL, et al. Pancreatic Cancer. Springer Science+Business Media 2010.

6. Shah A, Fehmi A, Savides TJ. Increased rates of duodenal obstruction in pancreatic cancer patients receiving modern medical management. Digestive Diseases and Sciences 2014; 59:2294−8.

7. Tender DA. Malignant gastric outlet obstruction: bridging another divide. Am J Gastroenterol 2002;97:4−6

8. Ducreux M, Cuhna A, Caramella C, et al. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 2015;26:56−68.

9. Čečka F, Jon B, Dvořák J, et al. Paliativní chirurgická léčba nádorů pankreatu a periampulární oblasti. Klin Okol 2012;25:117−23.

10. Malik NK, May KS, Chandrasekhar R, et al. Treatment of locally advanced unresectable pancreatic cancer: a 10-year experience. J Gastrointest Oncol 2012;3:326−34.

11. Willet CG, Czito BG, Bendell JC, et al. Locally advanced pancreatic cancer. Journal of clinical oncology 2005;23:4538−44.

12. Sultana A, Smith CT, Cunningham D, et al. Meta-analyses of chemotherapy for locally advanced and metastatic pancreatic cancer. Journal of clinical oncology 2007;25:2607−15.

13. Loveček M, Skalický P, Klos D, et al. Resekabilní karcinom pankreatu – 5leté přežití. Rozhl Chir 2015;94:470−6.

14. Li D, Xie K, Wolff R, et al. Pancreatic cancer. The Lancet 2004;363:1049−57.

15. Lowenfels AB, Maisonneuve P. Epidemiology and risk factors for pancreatic cancer. Best practice and research clinical gastroenterology 2006;20:197−209.

16. Bakkevold KE, Kambestad B. Morbidity and mortality after radical and palliative pancreatic cancer surgery – risk factors influencing the short-term results. Annals of Surgery 1993;217:356−8.

17. Wong YT, Brams DM, Munson L, et al. Gastric outlet obstruction secondary to pancreatic cancer. Surg Endosc 2002;16:310−2.

18. Spinelli GP, Zullo A, Romiti A, et al. Long-term survival in metastatic pancreatic cancer. A case report and review of the literature. Journal of Pancreas 2006;7:486−91.

19. Vincent A, Herman J, Schulick R, et al. Pancreatic cancer. The Lancet 2011;378:607−20.

20. Glimelius B, Hoffman K, Sjoden PO, et al. Chemotherapy improves survival and duality of life in advanced pancreatic and biliary cancer. Annals of Oncology 1996;7:593−600.

21. Ryska M, Dušek L, Pohnán R, et al. Kvalita života je důležitým faktorem indikační rozvahy u nemocných s pokročilým karcinomem pankreatu – multicentrická prospektivní studie. Rozhl Chir 2012;92:199−208.

22. Hucl T. Cílená léčba karcinomu pankreatu - minulost či budoucnost? Gastroent Hepatol 2013;67:366−76.

Štítky
Surgery Orthopaedics Trauma surgery
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